The Neurobiology of Trauma: Understanding How Trauma Shapes the Mind and Body
Trauma is not simply a difficult memory or a painful experience that fades with time. Trauma is a physiological event—a moment when the nervous system encounters something perceived as life-threatening and responds with activation of the fight-flight-freeze response. When this response is overwhelming, prolonged, or repeated, it leaves lasting imprints on the brain and body. Understanding this neurobiology is essential to understanding why trauma-informed care works.
When a person experiences trauma, the amygdala, the brain's threat-detection center, becomes hyperactive. Simultaneously, the prefrontal cortex, which handles rational thinking and emotional regulation, becomes less active. This neurological shift makes sense evolutorially: in the face of immediate danger, the brain prioritizes survival over deliberation. However, when trauma is severe or repeated, this state can become chronic. The nervous system remains in a heightened state of vigilance, perceiving threat even in safe situations. The body stays primed for danger, flooding the system with stress hormones like cortisol and adrenaline.
This dysregulation of the nervous system manifests in multiple ways. Individuals with trauma histories often experience hypervigilance—a constant scanning for danger. They may startle easily, have difficulty sleeping, or experience intrusive memories that feel as immediate and threatening as the original trauma. The body may hold tension, pain, or numbness. Emotional regulation becomes difficult; feelings can shift rapidly and intensely. Relationships become fraught with difficulty because the nervous system interprets normal social interactions through a lens of threat.
Importantly, these are not character flaws or signs of weakness. They are the predictable neurobiological consequences of trauma. The nervous system has been shaped by overwhelming experience, and it requires specific, evidence-based interventions to reshape itself toward safety and regulation.
The Five Core Principles of Trauma-Informed Care
Trauma-informed care is built on five foundational principles that guide how treatment is delivered and how therapeutic relationships are structured. These principles emerge from decades of research on trauma and recovery, and they fundamentally reshape how clinicians approach their work.
- Safety is the first principle. Before any therapeutic work can occur, the client must experience the treatment environment as safe. This means physical safety. A clean, secure space. But also psychological safety. The clinician must be predictable, consistent, and transparent about what treatment involves. Clients need to understand what will happen in sessions, how their information will be handled, and what their rights are. For individuals whose trauma involved violation of boundaries or betrayal by authority figures, this explicit attention to safety is not optional; it is foundational.
- Trustworthiness extends safety into the relational realm. Clinicians must be honest, follow through on commitments, and explain their clinical reasoning. There are no hidden agendas or surprise interventions. When a clinician says they will do something, they do it. When they make a mistake, they acknowledge it. This consistency gradually helps the nervous system learn that this particular relationship is different from the relationships in which trauma occurred.
- Choice and control recognize that trauma fundamentally involves a loss of control. Trauma-informed care restores agency by offering choices wherever possible. Clients choose whether to sit or stand, where to sit in the room, what topics to discuss in a given session, and what pace of work feels manageable. This is not permissiveness; it is recognition that the therapeutic process itself can be retraumatizing if the client experiences it as something being done to them rather than something they are actively participating in.
- Collaboration means that the clinician and client work together as partners rather than the clinician positioning themselves as the expert who knows what the client needs. The client is the expert on their own experience. The clinician brings clinical knowledge and skills, but these are offered in service of the client's goals and understanding. This collaborative stance is particularly important for individuals whose trauma involved being silenced, dismissed, or having their experience invalidated.
- Empowerment and strengths-focus shift the lens from pathology to resilience. Rather than focusing exclusively on symptoms and deficits, trauma-informed care recognizes the strengths and coping strategies that have allowed the individual to survive. It builds on these strengths while addressing the ways that survival strategies may no longer serve the person well. This strengths-based approach is profoundly different from traditional mental health models that focus on what is broken and needs fixing.
Evidence-Based Therapies for Trauma
Several specific therapeutic approaches have strong empirical support for treating trauma. These therapies work by helping the nervous system process traumatic memories and gradually learn that the threat has passed.
- Eye Movement Desensitization and Reprocessing (EMDR) is one of the most extensively researched trauma treatments. In EMDR, the client recalls the traumatic memory while simultaneously engaging in bilateral stimulation, typically eye movements, but sometimes tapping or sounds. This dual attention appears to help the brain process the traumatic memory in a way that reduces its emotional charge. The mechanism is not fully understood, but the efficacy is well-documented. EMDR can be particularly effective for single-incident trauma and for individuals who struggle with talk-based therapies.
- Somatic Experiencing focuses on the body's role in trauma processing. This approach recognizes that trauma is stored not just in memory but in the nervous system and the body. Somatic experiencing helps clients develop awareness of bodily sensations and learn to complete the physiological responses that were interrupted during trauma. For example, if someone froze during a traumatic event, somatic experiencing might involve gradually mobilizing the body in ways that allow the nervous system to complete the fight or flight response that was thwarted. This completion allows the nervous system to return to baseline.
- Dialectical Behavior Therapy (DBT), while originally developed for borderline personality disorder, has proven highly effective for trauma survivors, particularly those with complex trauma histories. DBT combines individual therapy, skills training, phone coaching, and therapist consultation teams. The skills (mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness) directly address the dysregulation that trauma creates. For individuals with trauma histories who struggle with self-harm, suicidality, or emotional dysregulation, DBT provides concrete, practical tools.
- Cognitive Processing Therapy (CPT) helps individuals process traumatic memories by examining the thoughts and beliefs that have developed around the trauma. Trauma often creates distorted cognitions; beliefs that the world is entirely dangerous, that the individual is fundamentally damaged, or that they were responsible for the trauma. CPT helps clients examine these beliefs, recognize how they developed, and gradually shift toward more balanced and adaptive thinking.
- Prolonged Exposure Therapy involves gradually and repeatedly recalling the traumatic memory in a safe therapeutic context until the memory loses its emotional intensity. This works through a process called habituation—repeated exposure to the memory without the feared consequence (harm) gradually teaches the nervous system that the memory itself is not dangerous.
Trauma in the Jewish Community: Historical and Contemporary Dimensions
Trauma is not distributed equally across communities. The Jewish community carries particular historical and contemporary trauma that shapes individual and collective psychology. Understanding this context is essential for trauma-informed care with Jewish clients.
The Holocaust represents a collective trauma of unprecedented scale. While most living Jews did not directly experience the Holocaust, its effects ripple through families and communities. Research on intergenerational trauma suggests that children of Holocaust survivors may carry physiological and psychological effects of their parents' trauma. Beyond the Holocaust, Jewish history includes centuries of persecution, pogroms, expulsions, and discrimination. This historical trauma shapes cultural narratives about safety, belonging, and the precariousness of Jewish life.
Contemporary antisemitism continues to create trauma for many Jewish individuals. Hate crimes, harassment, conspiracy theories, and discrimination create a lived experience of being targeted and unsafe. For Jewish individuals navigating predominantly non-Jewish spaces, there is often a hypervigilance about whether it is safe to be openly Jewish, whether antisemitic comments will be made, and whether one will be scapegoated or blamed for various social problems. This chronic stress and threat vigilance can create trauma responses even without a single discrete traumatic event.
Immigration trauma also affects many Jewish families. Families who fled persecution, pogroms, or the Holocaust carry trauma related to displacement, loss of home and community, and the terror of flight. These experiences shape family dynamics, parenting styles, and individual psychology across generations.
Additionally, the Jewish community has historically carried significant stigma around mental health and addiction treatment. This stigma can prevent individuals from seeking help, leading to prolonged suffering and more severe mental health crises. Trauma-informed care with Jewish clients must address not only individual trauma but also the cultural context that may have prevented earlier intervention.
The Connection Between Trauma and Addiction
The relationship between trauma and addiction is profound and bidirectional. Individuals with trauma histories have significantly higher rates of substance use disorders and behavioral addictions. Conversely, addiction often develops as a response to trauma. Addiction becomes a way of managing the overwhelming symptoms of dysregulation, intrusive memories, and emotional pain.
Addiction serves a function in the context of trauma. Substances and addictive behaviors provide temporary relief from the unbearable symptoms of trauma. They numb emotional pain, quiet the hypervigilant nervous system, and provide a sense of control or escape. From this perspective, addiction is not a moral failure or a character defect; it is an understandable, if ultimately destructive, attempt to manage trauma symptoms.
However, addiction creates its own trauma. The shame, legal consequences, damaged relationships, and loss of control that accompany addiction compound the original trauma. The individual becomes trapped in a cycle where they are using substances to manage trauma symptoms, but the addiction itself creates new trauma and deepens the original wounds.
Effective treatment of addiction in individuals with trauma histories must address both the trauma and the addiction. This is not sequential—first treating trauma, then addiction, or vice versa. Rather, it is integrated treatment that recognizes how the two conditions interact and reinforce each other. Trauma-informed addiction treatment helps individuals develop new, healthier ways of managing trauma symptoms while simultaneously addressing the addiction itself.
Trauma-Informed Care in Practice: What It Looks Like
Trauma-informed care is not a specific technique or protocol; it is a lens through which all clinical work is conducted. In practice, it means that clinicians are constantly asking: How might this intervention be experienced by someone with a trauma history? Where might I be inadvertently retraumatizing? How can I offer this intervention in a way that restores agency and choice?
In a trauma-informed intake, the clinician gathers information about trauma history but does so gently and with explicit consent. The client is never forced to disclose trauma; they are invited to share what feels safe. The clinician explains why certain information is being gathered and how it will be used. The client is told that they can pause or stop at any time.
In trauma-informed therapy, the clinician pays attention not just to what the client says but to how they say it and how their body responds. If a client becomes dysregulated, the clinician pauses the work and helps the client return to a regulated state. The goal is never to push through dysregulation but to work at a pace that allows the nervous system to gradually expand its window of tolerance.
Trauma-informed clinicians are transparent about their clinical reasoning. If they are recommending a particular intervention, they explain why, what it involves, and what the client can expect. They invite questions and concerns. They acknowledge that the client is the expert on their own experience and that the clinician's role is to offer tools and support, not to impose solutions.
Trauma-informed care also means attending to the therapeutic relationship itself. The relationship is not incidental to healing; it is central. A consistent, attuned, trustworthy therapeutic relationship provides a corrective emotional experience, an opportunity to experience a relationship that is different from the relationships in which trauma occurred. This relational healing is as important as any specific technique.
Beginning Your Healing Journey
If you have experienced trauma and are struggling with anxiety, depression, addiction, or other mental health challenges, trauma-informed care offers a pathway to healing that honors your experience and respects your agency. Healing from trauma is possible. The nervous system can learn new patterns. Relationships can be repaired. Life can feel safe again.
At Tikvah Center, our clinicians are trained in trauma-informed care and in evidence-based trauma therapies. We understand the particular dimensions of trauma in the Jewish community. We create environments where safety, choice, and collaboration are foundational. If you are ready to begin healing, we are here to support you.