What Happens in the Brain During Trauma? [Infographic]

After trauma, our clients are often left with many painful sensations and emotions . . .

. . . including shame and guilt.

And that’s especially true if they weren’t able to protect themselves or escape.

That’s why it can be so useful to help our clients understand how their brain and body did work to protect them during the traumatic event.

Because when people find out that their response was an adaptive reaction that helped them survive, that can open the door to healing.

So we thought it would be helpful for you to have a way to illustrate this for your clients. (Please feel free to share a copy with them.)

Click the image to enlarge

If you’d like to print a copy to share with your clients, just click here: Color or Print-friendly

(Please be sure to include the copyright information. We put a lot of work into creating these resources for you. Thanks!)

You can hear more about how trauma affects the brain, body, and nervous system in the Treating Trauma Master Series.

You’ll get insights from Bessel van der Kolk, MD; Pat Ogden, PhD; Dan Siegel, MD; Stephen Porges, PhD; and Ruth Lanius, MD, PhD.

Now we’d like to hear from you. How will you use this in your work with clients? Please leave a comment below.

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63 Comments

  1. Elena says:

    Thank you for this wonderful series.
    Do you support offering or suggesting non-verbally to the patient attachment to Self as a safe attachment approach?
    In my work as a Bodywork practitioner I feel very responsible for the non verbal impact I’m creating in the world, and I will appreciate your input on this. I stumbled on trauma stored and released in the body for 25 years; I had to take millions of classes (under the suggestions of the psychology professionals I work with) on Somato-emotional Release, Psychodrama, other PTSD approaches etc., in order to feel capable of offering a safe first response to the patient. Trauma shows up in a Bodywork session inevitably, so I had to learn a safe first-response strategies. I have found that if I manage to facilitate a still-point non verbally- through CST or Visceral Manipulations and enhance this with the patient creating his Dance-Life-Map(non-verbally, again) during the session, he/she is less likely to seek safe attachment to external source. In my work with cancer survivors, I found that using apilado-style Tango helps them to regain faster their eroded sense of self-trust, nonverbally. These patients’ mental health professionals report that they achieve lower levels of state anxiety , trait anxiety and pain faster.

  2. I suffered an unimaginable amount of violence and trauma and kept all of this to myself… when my only daughter was born I prayed that she would never suffer as I did… when my daughter was diagnosed with RSD/CRPS the most painful condition in medicine I knew it was all my fault! The damage to my brain without a doubt affected her central nervous system… overcome with guilt daily.

    • Mike Wallace, LPC says:

      I question the statement “I knew it was my fault”. “Knew means that you have verifiable evidence and “fault” suggests that you were intentional or negligent.

  3. Robin Williams says:

    I work with women who have experienced trauma when discovering their husbands are viewing pornography. Many have been told they have PTSD and do experience triggers as I did, even years after the initial discovery.
    I want to learn everything I can to help these ladies become free of the trauma that keeps them from moving forward in their lives. This information and graphic even helped me experience a new level of freedom from the shame.

  4. Thank you Ruth, the diagram is really helpful to explain to clients so they can begin to feel less ashamed and guilty about their feelings of helplessness after trauma

  5. Turid Hopwood says:

    Aside from education I would try and empower the client to find ways of escape that are safe and I will help the client identify his/her social support network.

  6. Thank you for this beautiful work. You inspire me to offer more and more quality education.

  7. Karen says:

    I truly appreciate the excellent tools, language and education that I can relate to as a professional and an ordinary human. Thank you!

  8. Clemmy says:

    I wore a heavy mantle of guilt, grief and shame associated with a trauma related freeze response. It fuelled suicidal self loathing. I despised myself for my inability to manage the trauma time better. It became a constant all consuming toxic loop playing in my head, emphasising my helplessness and magnifying my shame, eroding my sense of self. Why did I not react differently?

    A wonderful psychologist put it succinctly into perspective for me. If an animal can fight its way out of imminent danger, it will do so. If the animal can not fight its way out of imminent danger it will flee if it can. When both fight and flight are simply not options for survival, the final response is freeze. He said freeze response is most often associated with PTSD, because the actions of fighting and fleeing are both active and consciously chosen self protection. Freezing is the last chance to survive and is the saddest because the brain realised was simply no other option for survival at that time.

    Understanding this was profoundly healing. Freezing wasn’t a personal weakness or flaw. Nor was it even a choice. It was because it was the only survival mechanism left available to me. Learning this gave me the ability to understand why, and replace guilt and shame and self loathing with self compassion.

    • Julie says:

      Clammy, I LOVE that response, it’s so powerful to be able to use metaphors in helping people understand things better, glad it helped you

  9. Karen says:

    Having dealt with counselors who don’t know how to help but only offer sympathy for the pain trauma victims experience I find your information uplifting and full of hope. I hope many more counselors realize people come to them to get better. Not just for sympathy and diagnoise but to make their lives better.

  10. julie says:

    I live very rural and have been doing self therapy with the help of all the books and videos mentioned on this site. I have layers of trauma and have gone into freeze mode so many times. When I learned about freeze mode, to release my shame, I have been telling myself how proud of myself I am. That I can trust myself, my brain was protecting me during these horrendous events. Another commenter mentioned Highly Sensitive Person. When I learned that I was a HSP so many things began to finally make sense. Though this journey is a challenge, boy is it liberating! Thank you so much for all the free information you share.

  11. Thank you for this excellent handout. I will use it today with a client who is experiencing shame and guilt about a freeze response.

  12. Tobias Schreiber says:

    Great information. This puts you ahead of the curve on all information on treating trauma.Great presentations and in an easily useable format.Thank you.

  13. Carol steinberg says:

    I was molested beaten and neglected.. I have survived, married had 4 children and
    Grandkids.
    Years and years of therapy ,addicted to severe
    bulimia which tapered off and finally conquered.

    I had to learn to refuse disrespect ..
    Did not know how to defend myself.
    I had such low self esteem.
    I would freeze as I did as a child when I would dissociate
    And “fly “ out of the room thru the window.
    I still wake every morning in a panic attack a
    Feel terrible emotional pain.
    I don’t know what happened in my bed or if
    My father masturbated at the end of my bed.
    Cause I remembering trying to sink into the mattress.

    The pay off is a
    Daughter a psychologist and a grandaughter in
    Medical school, a husband I love.

  14. Malcolm Stanislaus says:

    Thank you for your heartfelt endeavors! This information is so effectively summarized and extremely helpful in supporting our clients’ understanding.

  15. Thank you so much for all these wonderful resources that you provide!

  16. Laurel MacIsaac says:

    This is a wonderful tool. Is there any way to adjust the language to a grade 2-3 reading level? I find as an RN it is technical and good for professionals. For some clients who have experienced trauma may get lost in the language and the message it is trying to send will be lost.

  17. Andyou says:

    Cool- printed off 23 to use in surgery today- and then actually realised the words are a bit long and likely to stimulate disengagement so will be refining this material into a ‘dumbed down’ version to fit 1 page of A4 and engage on the level of my clients reasoning and literary abilities.

  18. Marsha Kirzner says:

    I find this really interesting in terms of working with myself.

  19. Thank you so much! A clear explanation of trauma. I will definitely use it in my work with survivors of domestic abuse.

  20. Kim O'Donnell says:

    Thank you so much for these wonderful infographics! I work with children and find these are fantastic, easy to understand ways to help them. I use Rick Hanson’s “A Quick and Simple Way to Think About the Brain” with them all the time and they really love it. This will be a fantastic addition to the wonderful resources you provide. It’s so helpful for them to be able to understand the biology and science behind why things happen rather than thinking there’s something wrong with them when they respond in this way to threats.

  21. Kerisma Vere says:

    Thank you As a coach and as a person with complex PTSD aarising from multiple traumas I have been following your various series on trauma. Simply having more information is helping me in many ways. For years My focus was to cure or make it go away but now I am working towards finding out more about what it is and how it actually affects me and what strategies will actually allow me to progress. I very much appreciate you making this series available for free so that I will be able to watch. Learning is part of the healing process for me.

  22. Trudy says:

    Thank You! Understanding frees a person to heal, so tools like this help greatly to begin both the understanding and the healing.

  23. Angela says:

    Thank you so much I am currently working with a lady who was raped by a stranger when she was 25, she is now In her 50,s and it has impacted on her life so much. She has not disclosed this information to any of her family and constantly feels ashamed.

  24. Dianne VeeTee says:
  25. Mike Wallace, LPC says:

    To help free them of guilt and shame that they froze in the situation.

  26. Barbara Caspy says:

    Thank you! Although I emphasize to my clients who have experienced trauma that it’s not their fault that they were helpless and couldn’t fight back, I think that they will be more accepting of this when they see the visual explanation that you’ve presented. They won’t think that it’s just me telling them that. The visual with the explanation makes it more objectively possible for them.

  27. Nice the truth is out! For many years I was amazed at the way my brain had a distinct picture of “the bears” that stayed with me for a couple of weeks and would interfere with my thoughts. This was after getting chased a few miles by 8 Kodiak bears in Alaska and of course out running them. Rather than celebrate being the victor, my brain insisted on going back to the images, which I always though curious and have wondered if others have similar experiences. Since the images were so clear I thought Art as therapy might be helpful for people to conquer these kinds of lingering demons; If you paint or draw them yourself you can control their posture and vulnerability.It really is about being the victor not simply survival.

  28. Jane Vance says:

    Thank you so much,
    The information is wonderful and I am so pleased you are sharing with the world.

  29. Diana says:

    this is just wonderful thank you sincerely

  30. Mary Payne says:

    Your analysis is always so “on target.” Thank you!

  31. Betsy says:

    A few months ago, I read a piece about a fourth response to traumatic events: “fawning.” After suffering maternal neglect during infancy, my adoptive mother became frighteningly rageful that could last weeks at a time. Freezing or fleeing was not possible. Instead, I fawned over her, providing her the narcissistic supply she demanded. It did not endear her to me, and eventually she became livid when she thought I was manipulating her. Then I froze when she raged, and was beaten. I fled from home at 15, encouraged by my dad who never tried to protect me. Throughout I was told I was fortunate because she “chose” me by adopting me despite my many flaws. TMI? My point is that I tried all varieties of therapy, except for electric shock. Yet I my predilection is reflective and often sad. I hope therapists reading this recognize some clients will try ANYTHING to “let go” of these experiences, work with interventions for many years, and never experience the spontaneous joy and freedom “normal” people do. Sadly, some medications actually work but are refused as being potentially addictive.

    • Marcia says:

      Betsy, Sorry for the longterm trauma. It is quite disheartening that parents, adoptee or otherwise have not been trained how to parent. That causes a lifetime of damage. A book called Childhood Disrupted has been helpful in this understanding coupled with a longitudinal study by Kaiser Insurance that shows these issues in a questionnaires with a resiliency quiz that I find quite affective to help clients see what went wrong and how to start the healing process. All this new research has helped me no longer work from that very competent Sympatheric Nervous System that Porges speaks of and stop ignoring the repressed wrongs. It is hard work and you need a competent counselor to help you grow from the work as it can be very disruptive to your usual way of dealing with an ongoing functioning. It is like finally waking up and wanting to crawl back under the covers and diving into the Parasympathetic Nervous system. This healing is a lot of work, but once it is started it becomes easier and more and affective as reality enters you psyche instead of avoiding. Just knowing it is only the beginning, It is like Peter Levine says, now you need to acknowledge the body response. Gradually you awaken to what life is and realize what a wonderful world we can make it, if we work hard at shifitng the wonderment of the world back to our early two or three year old awe. All this information does fit. You will start to smell, feel all those things that got repressed with the traumas. I was lucky as I started my BA clinical work loving developental stages. This helps give you a clue how to reparent our younger neglected selves, without blaming those adults who were raised without the accurate information. Being a family specialist has been my greatest world for healing what these families never knew. The nervous system was the avenue to see it from the body instead of the eyes. i was waiting for the eyes to be spoken of and here it is. I have a lot of history in that study and find it quite fascinating. The “eyes do have it.”

      • Betsy says:

        Thank you, Marcia. I immediately purchased “Childhood Disrupted” and it describes my circumstances perfectly. It also synthesizes the most recent brain research on childhood trauma in a way that is accessible to readers somewhat familiar with brain structures, functions and development. I now recognize that I’ve been reading all around the very book that addresses my increasing anxiety over the years and explains my lifelong self-blame and -shame. However, it is hard to read more than a few small sections at each reading, because a “diagnosis” can surface both relief and anxiety. Relief that my mystery is understood by wise people doing good research, and anxiety that it is too late to heal. But I am finally hopeful! I have yearned to understand move beyond the trauma, and experience sustained joy and peace of mind. I am grateful for your insights!

    • Mary Payne says:

      Betsy, I am so sorry for your pain. Sadly, there are other adoptees who have had similar scenarios. You might benefit from accessing some adoptee websites and/or Facebook pages. One I like is “Hello, I’m adopted.” Anne Heffron, author of “You Don’t Look Adopted,” started the page to get some of us together. It’s been beneficial for me, and other people as well. At least we don’t feel so alone.

    • Beth Hack says:

      Betsy have you tried Myofascial Release therapy?

  32. Therese josefsson says:

    Very useful,basic and succinct.

  33. Marcia says:

    Thanks, I always inform clients of the people responsible for the information as I believe it is helpful for them to know the extent of the issues and who is responsible for the research. I refer clients everyday to all of the information, research and recommend books to clients regularly and they take photos of the books as I keep them in my office. Used to do a syllabus but phones nowadays help them in a more productive manner. They can peruse the book before they even take a pix. In all my years I have never taken credit for what I learn but spread the information. Only thing that gets in their way are my notes on each books margins. Books are such wonderful tools especially when they are going on trips, so please keep writing all of you. I would especially like to see what the yoga intructor has written as I have not seen her on recent videos. I so wanted to take your last series and now regret having missed the opportunity. I will keep abreast for next year.. Thanks for the handout which I share with certain clients at the appropriate time.

  34. Eva-Lena Kost Fehlmann says:

    Thank you so much for your most valuable contribution, always. As a trauma survivor myself, I think it is important, while working with traumatized people, to distinguish who is a HSP (high sensitive person) and who is not. I myself worked for many years on my traumas thinking I would reach a certain point, which I now realize that I will never reach being a HSP. This means that the deep processing, perceiving the environment at a very subtle level while at the same time feeling extremely connected to a certain “whole”, do not belong to my traumas as I thought for years. It would have been easier for myself to come to conclusions with my traumas if someone would have told me from the beginning that I am a HSP. Hope this will help someone.

  35. Maggie Baumann, MFT, CEDS says:

    As always, thanks for providing information about trauma/brain is this visual form. What an asset to share with my clients so they understand. Your generosity is healing on many levels as we reach out to our clients.

  36. Gina says:

    Oh, thank you, this is perfect. We have adopted children who suffered trauma in their birth home. It has helped me with another piece of the puzzle and I will use it as a base to work from with my eleven yro who feels so much guilt for not running away or fighting, even though he was less than three years old. I think this will be an amazing resource for our family.

  37. Marion Geyer says:

    I sent it to others on FB and perhaps we can do this together. I want to learn from all your years of experience, even though I am retired and want to take it easy, I aso realize that so many traumatized people are a growing groep that need all the help they can get. I can’t afford to buy the package but I am eager to learn from your expertise. I live in th Netherlands and I don’t have a credit card. If there is another way, let me know please. Perhaps with a groep of people like the telephone helpline I am on? That’s why I sent a message to them and many others therapists. I am an art therapist and reconnection healer and even though I am retired, I still feel the need to help others, especially now. Thanks for your knowledge. Luv, Marion

  38. Rach Wood says:

    Thank you!!! I appreciate you sharing this info.I am trapped in a PTSD body after being an RN for 20years.

  39. Edit Hackl says:

    Thank you for this analysis. Flight – Fight – Freeze – It’s so important to think these reactions as the reactions of your brain which come automatically, beyond your will and conscious thinking. So the “freeze” reaction cannot be your fault, you need not be ashamed of and need not be guilty of andtherefore must not be blamed of … not by others and – mainly – not by yourself. That’s what I’ve learnt by your graph and I thank you very much for that – for myself and for my students who are refugees, most of them. How to tell them to get them some release of their pain attacks? – Our brain is tricky, just to help us stay alive. Think of that …
    Warmly
    Edit – English is not my mother tongue …

  40. Diane says:

    A particularly helpful graphic, Ruth. Thanks so much for sharing it freely!

  41. renee friedman says:

    I was molested in an elevator when young. I never told my parents and feigned a reason to have them come get me rather than taake the eevator myself. For years I was sure it was my fault for ‘freezing’ and whenever men harrassed me I was sure it was because they knew I was ‘easy’ I felt so guilty it was not untilI was an adult that I ever told anyone. This piece of information just added another layer to why it wasn’t my fault and why my body chose what it did.

  42. Sam Heine says:

    We always see the first reaction as fight or flight. I have done the following experiment with a lot of people: While they are relax and look at you, walk straight, determent and quick up to them. Ask them what they experienced. What we almost always experience is a little burning sensation in our joints (Knee and elbows), but is mostly minute and only a flash of an experience. Then we will have a urgent feeling of getting “out” or “away”. When we feel that there is no way out (Because we are against a wall or sitting in a chair and there is no way out, the next feeling we have is fight – making ready to defend ourselves. This indication for me is how the “brain” has prioritized these responses. So here is the sequence: Freeze – Flight – Fight. But as we have learnt that flight and fight is the best ways to survive, we would not want to freeze – that is why we only experience that burning sensation for a moment, we have to get out of the stuckness! Therefor we would rather fight or flee! And I believe that this FREEZE is what is causing us trauma – it creates a feeling of hopelessness! No movement! No survival! As you indeed even describe it as: shutdown! We must teach them how to be able and get unstuck, make the transition from stuck to unstuck… therefor reframing is sometimes helping them… because they realize that there was other situations and instances where something similar did not get them stuck or in shutdown mode!

    • Sam Heine says:

      And thanks for your good work.

  43. Jane Harris says:

    Most everything about trauma and fear involve the fight or flight response only. It’s great to have the freeze response also illustrated.

  44. Rosemary says:

    I have students from several countries where they themselves might have experienced traumatic events. This infographic will be useful. I will use it for a vocabulary lesson, and it will become a tool to open the door to discussion of where to get help. Many people turn to family or well-meaning members of their community who may not be the best people to help. Thank you to NICAMB – as always.

  45. JoAnn Baird says:

    Thank you! These are always helpful.

  46. Paula Allen says:

    The infographic was very helpful in learning what happens internally.

  47. April Afoa says:

    I will let clients know how resilient and adaptive they were to protect themselves. I hope to learn more for helping them relax their now over stimulated fight of flight response to situations that are not traumatic but are triggering.

  48. Very useful, succinct and science-based summary. Thank you for this great contribution.

  49. Cherune Clewley says:

    Thank you for this. There are so many who are struggling with this, just knowing their own body automatically reacts will help them so much.

  50. Dawn says:

    Thank you, as a survivor from parental sexual, emotional, physical abuse, and years in an abusive, authoritative cult, this information is deeply appreciated.

  51. Nancy says:

    Thank you very much.

  52. Rochelle says:

    Thank you so much.

  53. Laura Adams says:

    This is terrific, thank you. I’ve had many clients and students find some relief in learning the freeze response is a natural, adaptive response, and not about cowardice.

  54. Doris M. Mason says:

    I will use it both with those who have suffered different traumas and also for some of my clients who have inflicted trauma and are working to understand the deep harm experienced by the one they harmed. This I believe will aid both the one who was traumatised and the one who traumatized the other in understanding the consequences of trauma. If the trauma was from a person who wants to express accountability for the harm and also empathy for the one hurt then this will be very helpful.

  55. Kim Lec says:

    Thank you for this, it’s really helped me understand my own and possibly consequently others’ response to trauma. Many thanks for this information.

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