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What Happens in the Brain During Trauma? [Infographic]

181 Comments

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

a traumatized brain infographic

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!)

If you’re interested in more ways to work with the brain’s response to trauma, you can get some of the top strategies in our Advanced Master Program on the Treatment of Trauma.

In this program, you’ll hear more from Stephen Porges, PhD, along with Bessel van der Kolk, MD; Pat Ogden, PhD; Peter Levine, PhD, Thema Bryant-Davis, PhD, and other leading experts in the field. Just click here.

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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Related Posts: Brain, Infographics, Trauma, Trauma Therapy

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181 Comments

  1. Sioux M, Other, Endicott , NY, USA says

    I’m not a counselor or therapist. I’m just an individual healing from abuse. This helps me understand what happened when I was attacked by my husband. I can keep moving forward in healing from my 30+ years of abuse. Maybe one day I will be able to socialize again.

    Reply
  2. Leslie Raddatz, Counseling, WI, USA says

    I will use this handout to explain for an example of flight, fight or freeze response. I will also use this to help those who have difficulty with blaming self for sexual assault because alot of anger toward self occurs and questions come up about why didnt I do something such as run, fight back etc. I would use handout to explain freeze response. Also with addiction clients with severe trauma which cant remember parts of what happened to them. There are so many ways to use this handout. Thank you for developing.

    Reply
  3. Leonie Eastment, Counseling, AU says

    I’ll definitely print a copy for relevant clients. Many thanks.

    Reply
  4. Pauline Powlesland, Psychotherapy, GB says

    This is excellent and very useful, thank you. I have recently had an accident and I am still experiencing some trauma even though I am feeling quite well and able to do some work. Your explanation of what happens in the brain has helped me to process my trauma. Grateful thanks.

    Pauline

    Reply
  5. Catrina Swan, Marriage/Family Therapy, GB says

    Thank you for this excellent resource. I am often explaining this verbally to clients, so it is really useful to have this handout to give them.

    Reply
  6. Joleen Thompson, Other, Las Vegas, NV, USA says

    The graph as a visual is a very good way of stimulation for understanding our physical and emotional way for a person to react to dangerous situations . Ty

    Reply
  7. Suzanne Clancy, Another Field, CA says

    Thank you so much for the info graphic… and for finally stating that this happens in the brain stem. I have had the privilege of working with people committed to understanding and surmounting their issues for over 20 years using various healing modalities including, Reiki, I.E.T. (our life issues are stored at a cellular level in the tissues of the body) and EFT (meridian tapping), and I am grateful to see the medical community catching up, this perspective will help so many people. I also wished to share that I recently started reading Bessel Van Der Kolk’s book on trauma; The Body Keeps Score. I am still in chapter one and I am blown away, as it seems it was discovered and documented that Trauma – PTSD has a physiological basis and therefore the treatment requires more than just talk therapy! I cried… finally are we at the Cross-roads? Are we ready to begin the process of incorporating non-traditional treatments to help one another heal? Thank you for being a light that shines on this truth. Suzanne Clancy C.C.A.C., C.I.A.C.

    Reply
  8. Alice Welbourn, Another Field, GB says

    Many thanks for this discussion. We also find it useful to talk about “fight or flight, freeze or appease” as a way of explaining this more – because some people manage by appearing to consent – eg to a rape – while in fact all they are trying to do is be in survival mode – ie not be killed or hurt too much – and they can then feel very guilty. And of course often the courts then judge against them. I would be really glad to hear your thoughts on this. Undoubtedly learning to understand that this is NOT THEIR FAULT and shows instead their instinctive resilience and skills at survival is a profound step towards managing to move forward from the trauma and rebuild their lives.

    Reply
  9. Rita De, Psychotherapy, CA says

    Thank you for this resource.

    Reply
  10. Miguel Lozano, Psychotherapy, ES says

    I think it´s very interesting. Thanks.

    Reply
  11. Shirley Roberts, Counseling, Albany, GA, USA says

    Thanks for sharing. this is good information

    Reply
  12. Elizab, Nursing, Little Rock, AR, USA says

    I’ve seen this shutdown trauma response in women trapped in an abusive marriage and it takes awhile to work through intense feelings associated with unsubstantiated shame and guilt before healing happens. Often the women did nothing wrong but were treated as if they were unworthy of existing by their abuser.

    Reply
  13. Nancy Brown, Nursing, Baltimore, MD, USA says

    Thanks for such a great and easy to discern tool!

    Reply
  14. Jeannie Higgins, Psychology, AU says

    Thank you- a very useful graphic. Warmly Dr Jeannie Higgins (Australia)

    Reply
  15. Margaret O'Carroll, Counseling, NZ says

    Very helpful and easy to follow resource….thanks.

    Reply
  16. Donia A, Teacher, PL says

    Thank you for the resources. They are very helpful. I will share this diagram with the teachers in the kindergarten.

    Reply
  17. Maggie Wright, Health Education, GB says

    Hi,

    I would include this in a very simple course that I use to help families to understand why their family member reacted in the way they have.

    As I am not “qualified” through external qualifications, but through experience, I have still found these Infographics to be perfect for me to share with others who have gone through trauma. Peer to peer resources. I of course, will always credit your organisation.

    Many thanks for providing this.

    Reply
  18. Beta Doe, Teacher, Hobe Sound, FL, USA says

    Spot on! Part of the brain may remain shut down as the rest functions normally. Another #me too person who blanked the rape out completely for 40 years, did trauma bonding and married the jerk. Divorced after 13 years and 3 children – there is my shame.

    Reply
  19. Rennik Soholt, Another Field, New York , NY, USA says

    Thank you for sharing this!

    Reply
  20. Maria Adkins, Dietetics, Cincinnati, OH, USA says

    Thank you very much
    Maria

    Reply
  21. Luana Graf, Social Work, Windom, MN, USA says

    I appreciate your information. I work with many foster and adopted youth who have a history of trauma.

    Reply
  22. Elisabeth Cravens, Counseling, Medford, OR, USA says

    In my work at the Veteran’s Administration and in private practice, it has been extremely helpful for clients to understand that this somatic response is not a choice. Thanks so much for these resources. I am enjoying the videos!

    Reply
  23. Laurie Elenbaas, Nursing, Panama City Beach, FL, USA says

    Very helpful As a person who went through robbery home invasion and theft this information is right on!!!! Thank you

    Reply
  24. Kay Sawyer, Psychotherapy, GB says

    This is a valuable resource. I work with adolescents (& younger children) & wonder if there is a way of translating this into a language that they may be able to understand & integrate? Many thanks for sharing.

    Reply
  25. Agnes Carbrey, Counseling, Lexington, VA, USA says

    I’m a Substance use disorder and addiction moderator in the group recovery process. I hear devastating stories every day. Many clients have childhood trauma of abandonment, beatings, sexual abuse. Substance use to escape emotional pain is their self medication, and as they tell it, addiction is the result. Lives get destroyed through incarceration, unemployment and stigma. Helping clients understand that they may have trauma and co-occurring disorders gives them insight as they begin to rebuild their lives in recovery. This is a beautiful and clear illustration. Thank you.

    Reply
  26. Jill G, Clergy, Peabody, MA, USA says

    It is a wonderful and helpful graphic. But, the way out of this response? if a person is conscious of it. And especially if the person is still in the conflict situation, (DV, etc.) In my experience of flashback, trigger PTSD/CPTSD events – and by the way, I am not a clinician , but an aficionado of healing technique. The new breathing science “Intermittent Hypoxia” has helped me to reset my sympathetic nervous system. There may be other methods.
    To consciously recognize the moment of the Five F’s (fight, flight, feed, freeze and fornicate – which this infographic keeps to the most basic!) and how to break this command chain to keep the abuse from reoccuring (without recurrent shame and guilt.) Next, please!

    Reply
  27. B A, Psychology, New York, NY, USA says

    This is great– Wondering if you have a Spanish version….

    Reply
  28. Angel Powers, Counseling, CA says

    Simple and informative! Thanks a lot

    Reply
  29. Sam Fores, Coach, CA says

    Great resource- many thanks for sharing.

    Reply
  30. Diana flame, Counseling, AU says

    thank you very much

    Reply
  31. Pat Quinn, Counseling, Orinda, CA, USA says

    Very, very helpful in expanding clients’ awareness of the trauma/reaction pathway.
    Thank you !!!
    Pat, Oakland

    Reply
  32. Betsy Ridgway, Other, Fullerton, CA, USA says

    Dear nicabm – Thank you so much! I’m a parent to two special needs boys, both adopted. We know that adoption can cause trauma, as it did when we adopted our older son at 4 years old. The younger son has brain injury (brain tumor as a baby). When the campus police surrounded him at school last year (age 26) he was seated quietly, nevertheless, they started aggressively interrogating him. He had no advocate next to him, unfortunately. His response was definitely neurological as stated above. He ended up in a psych ward and expelled from school, all because the campus police did not know how to communicate with a special needs adult. This ended up with a lawsuit! I will use the above info for the school personnel, to help educate them!
    – Betsy Kay Ridgway, M.S.
    Advocating for Special Needs Families

    Reply
    • Kim Alsbrooks, Other, Philadelphia , PA, USA says

      Campus police? How about all police. Many of the individuals they are dealing with are trauma people and they just make situations escalate or go wrong. They will prob never have an advocate and have to accept what happens, usually not good.
      Sorry that happened to your son. Glad you are working to help.

      Reply
  33. Margarita Paredes, Psychology, Austin, TX, USA says

    I will share it with the teachers at the elementary school I work in who are stressed!

    Reply
  34. Lynne Morg, Another Field, GB says

    What stage is it when u leave your body and watch on?

    Reply
    • Carol Benham, Nursing, GB says

      Dissociation. I believe they plan to cover that in a future video. All the best

      Reply
  35. Kendra Duval, Coach, Orem , UT, USA says

    Thank you, this is a great diagram and will be very helpful.

    Reply
  36. Jo Johnson, Social Work, Denver, CO, USA says

    So how does this explanation work with hyperfocus, a trauma response described by Jim Hopper, PhD, Harvard? Hyperfocus is often mentioned as tunnel vision in studies of first responders in highly dangerous situations.

    Reply
    • Harry Zeit, Medicine, CA says

      That’s an aspect of hyperarousal – sympathetic nervous system response. Those first responders are not shutting down, they are mobilizing. Their nervous systems are registering that it is safe (enough) to engage. A risk though – if they cannot regulate back down to a sense of calm and safety – they stay hyperaroused and hyper-focused during downtime. This requires treatment and is a big occupational hazard. The other risk is that over time, the stress accumulates and then the nervous system starts shutting down (burnout) and instead of hypervigilance, we have dissociation and disconnection. I’m seeing a lot of this in medicine now.

      Reply
  37. Linda Sunset, Psychotherapy, GB says

    Thank you for sharing. It is so important for trauma survivors to recognise that the responses during trauma where not a choice but a survival response. Self blame can be debilitating, particularly related to the freeze response and it is so important to help people understand this was not a conscious choice! This resource explains it so well!

    Reply
  38. Nancy Alexander, Counseling, CA says

    Thanks for sharing the info graphic, very helpful!

    Reply
  39. Gidget Wong, Counseling, GB says

    Thank you for so kindly sharing your excellent knowledge to us.

    The infograph is really helpful to me in my work with many of my traumatised clients. Thanks again.

    Reply
  40. Shawn Sallee, Another Field, Racine, WI, USA says

    Hi. This is so true for me experience of PTSD anxiety

    Reply
  41. Rich Buckley, Another Field, Livermore, CA, USA says

    Thank you for sharing

    Reply
  42. Rosemarie Nugent, Psychology, AU says

    Thats really helpful – thank you NICABM !

    Reply
  43. carol steinberg, Another Field, CA says

    This is exactly what happened to me nights I was molested.

    I can still go into that state.

    I can ignore physical pain because i was also beaten until I would dissociate and feel no pain.
    Fortunately I have had excellent therapy, happily married mother
    grandmother but still awake every morning in a panic.

    Reply
  44. Patricia Ann ( Pat) Kelly, Counseling, AU says

    Fantastic resource, thank you , Kind regards, Pat

    Reply
  45. Lucia Ortega, Psychotherapy, CA says

    Thank you! It is really well explained and will be very helpful to my patients.

    Reply
  46. Janice Castelbaum, Counseling, Bend, OR, USA says

    Fabulous! One of the best infographics nicabm has created, IMO. And “YES” to the identification that the traumatic response begins at the brainstem. Many people, including professionals, often refer to the response beginning at the limbic region. I’m thrilled and grateful that nicabm is sharing this important and accurate distinction.

    Reply
  47. Graciela Lopez, Student, Oklahoma City, OK, USA says

    Hi thank you for the information, I am in the need to write a paper and I am looking information about how the human is affected with trauma, I would like to be able to learn what happened to a person who has commitment issues, it is clear that this person was affected, but I would love to know why is the fear affecting this person, what happens with the brain.

    Reply
  48. Marilyn Newland, Psychotherapy, AU says

    Very user friendly. Like the simplicity of the explanation.
    Will use this. Thank you.

    Reply
  49. Anna Wang, Social Work, CN says

    Some clients may blame themselves for their not being able to run away or protect themselves when danger happened. I will introduce them how their body and brain decided what to do at that time in order to keep them survive,not their cognition, so they are not to blame.

    For example,one teacher may blame himself freeze not able to save students, and he felt very guilty. I would tell him, faced with so much fright, your body and brain choose to freeze to save you. Your cognition didn’t work at that time. So the result was not made by your cognition, it was made by your body and brain, esp. brain stem.

    Reply
  50. Jane doe, Other, New York , NY, USA says

    I am a #me too person who after sex abuse learned to comply instead of freezing. Reading suggests this is called ‘fawning’ . It’s rarely included in info/graphics let leads to shame / guilt and a lot of the misunderstanding of sexual assault reaction yet is not at all uncommon. It would be good to have a resource that includes this response / reaction to trauma.

    Reply
    • Theresa Weir, Psychotherapy, GB says

      I agree Jane.

      Reply
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