Natural responses to survive are not pathological but healthy. However, human beings whose natural survival mechanisms become survival strategies that leave the person in a constant state of hyper or hypo arousal. This video takes a closer look at the neurobiology behind the brain during and after trauma responses.
Please also review AIHCP’s Trauma Informed Care program and see if it matches your academic and professional goals.
Written by Shebna N. Osanmoh I, PMHNP-BC
Over the past ten years, ideas about meditation have changed a lot. People used to treat mindfulness as a one-size-fits-all fix for mental health problems. The common advice was simple: if you feel anxious, sit quietly; if you feel stressed, pay attention to your breathing.
However, as we move through 2026, emerging clinical evidence and longitudinal neurobiological research have revealed a more complex reality. For a significant portion of the population—particularly those with histories of complex trauma, Adverse Childhood Experiences (ACEs), or Post-Traumatic Stress Disorder (PTSD)—standard meditative practices can inadvertently worsen symptoms of traumatic stress.
This is not a failure of the student, but a failure of the framework.
Trauma-Informed Mindfulness (TIM), sometimes called Trauma-Sensitive Mindfulness (TSM), represents a systemic and essential “upgrade” to contemporary mindfulness-based programs. It integrates a sophisticated understanding of the human nervous system, the physiology of trauma, and the fundamental necessity of individual agency.
This thorough guide will explore the neurobiology of why traditional mindfulness fails for trauma survivors, the specific “adverse effects” to watch for, and the practical, evidence-based adaptations you can use to build a safe, healing practice.
To understand why a practice meant for peace can cause panic, we must look at the brain. Traditional mindfulness interventions often rely heavily on interoception—the practice of paying close attention to internal bodily sensations (e.g., “scan your body,” “feel your heartbeat,” “watch your breath”).
Research published in Frontiers in Psychology (2025) highlights a phenomenon known as the “Mindful Observing Paradox.” For the general population, observing internal sensations promotes regulation. However, for trauma-exposed populations, the act of “observing” can blur with a hypervigilant state focused on detecting threats.
Trauma is often stored in the nervous system as incomplete survival responses. When we remove all external stimuli and force the body into stillness, we may inadvertently simulate a “Freeze” response (immobility). For a survivor, being unable to move while feeling intense internal sensations can replicate the physiological experience of entrapment, triggering a cascade of stress hormones even as they sit “peacefully” on a cushion.
One of the most critical developments in the field (2024–2026) is the quantitative data regarding Meditation-Related Adverse Effects (MRAEs). Pioneering research by Dr. Willoughby Britton at Brown University and the Cheetah House organization has challenged the “no pain, no gain” mentality of meditation.
Dr. Britton’s team identified 59 categories of meditation-related experiences that can be distressing or associated with impairment in functioning. The statistics are sobering and essential for any instructor to know:
Trauma responses in meditation generally fall into two categories. While most teachers recognize the “loud” symptoms of trauma, the “quiet” symptoms are often missed.
a) Hyperarousal (The “Gas Pedal”)
b) Hypoarousal (The “Brake”)
Based on the “Procedural Modifications Checklist” developed for 2026 clinical applications, specific traditional instructions are now flagged as potentially contraindicated for trauma survivors.
The goal of trauma-informed mindfulness is not the mastery of stillness, but the cultivation of safety, choice, and self-regulation. To achieve this, we employ specific frameworks like the N.I.A. Language Model.
Developed to empower participants, this model shifts the power dynamic from the teacher to the student.
N – Non-Directive:
I – Invitational:
A – Adaptive:
When internal focus (interoception) becomes unsafe, we must offer external anchors. This engages exteroception—processing stimuli from outside the body—which helps re-orient the brain to the safety of the present moment.
Research confirms that external observing is more grounding for trauma-exposed populations and prevents the brain from being consumed by internal traumatic stimuli.
Beyond language, the structure of the practice itself must be adapted. The MINDS-V Study (Australian Veterans, 2025) demonstrated that tailored interventions led to significant reductions in PTSD symptoms even without increasing “mindfulness states,” proving that regulation is more valuable than “depth” for this population.
Trauma survivors often have a narrowed Window of Tolerance. Long sessions can push them into hyper- or hypoarousal.
For many survivors, movement is a clinical necessity.
PTSD symptoms thrive on unpredictability.
To move beyond theory, we must look at the data. One of the most significant recent contributions to the field is the 2025 MINDS-V Study, which evaluated a tailored Trauma-Informed Mindfulness-Based Stress Reduction (TI-MBSR) program for Australian veterans.
This study is critical because it challenges the assumption that “more mindfulness is better.” The intervention was culturally adapted to mirror military training routines, emphasizing discipline and perseverance, but with strict trauma modifications.
The “Mindfulness Paradox” Finding. The study yielded a fascinating result:
This suggests that the benefits of trauma-informed mindfulness may not come from achieving a deep, Zen-like state of awareness. Instead, the benefits likely stem from improved emotional regulation and the interruption of ruminative thought patterns.
For the practitioner, this is a liberating finding. It means you do not need to “clear your mind” or achieve perfect focus to heal. The simple act of practicing regulation—stopping the cycle of panic and returning to safety—is where the healing lies, regardless of how “mindful” you feel in the moment.
Trauma-informed mindfulness is not just for the meditation cushion; it is a framework for schools, healthcare, and justice systems.
Toolkits like the “Resilient Gwinnett Toolkit” emphasize shifting the mindset from “What’s wrong with you?” to “What happened to you?” Strategies include creating “calming corners” and focusing on peer support rather than punitive discipline.
Audit checklists now recommend reviewing waiting rooms and exam procedures to ensure “welcoming spaces” and “transparency,” ensuring patients know exactly what to expect during a visit.
Organizations like the Justice Resource Institute (JRI) train providers in de-escalation and vicarious trauma planning, recognizing that the “well-regulated facilitator” is the most important tool in the room.
The evolution of mindfulness toward a trauma-informed framework is not a rejection of tradition, but a maturation of it. We are moving away from a passive, potentially dangerous state of stillness toward a dynamic, active state of safety.
As we look toward the future of 2026, the goal is clear: theoretical and conceptual clarity. We must stop asking – Does mindfulness work? and start asking – Which type of mindfulness works for whom?
By integrating the N.I.A. Language Model, prioritizing external anchors, and respecting the Window of Tolerance, we can ensure that mindfulness remains a transformative tool for healing rather than a source of harm. The most important intervention is not the technique, but the genuine, attuned relationship between the teacher and the student—one that honors their survival and empowers their recovery.
Author Bio:
Shebna N. Osanmoh I, PMHNP-BC, is a board-certified psychiatric mental health nurse practitioner associated with Savant Care, CA, mental health clinic. He has extensive experience and a Master’s from Walden University. He provides compassionate, holistic care for diverse mental health conditions.
Please also review AIHCP’s Trauma Informed Care Specialist Certification programs and see if it meets your academic and professional goals. These programs are online and independent study and open to qualified professionals seeking a four year certification
Vicarious trauma reignites the counselor’s own trauma and makes the client’s trauma and manifests it within the counselor. Please also review AIHCP’s Trauma Informed Care program as well as its AIHCP’s Healthcare Certifications.
Shame, guilt, and fear complicate trauma counseling. These emotions shape the therapy process and the path to recovery. Clients often feel these emotions as obstacles to healing. They find it hard to express weakness or speak honestly with their counselors. Understanding these feelings is necessary. They worsen the mental impact of trauma and cause further isolation and distress. For instance, explains how abuse and trauma link to harmful emotional responses. These responses block effective treatment. Crises like the COVID-19 pandemic also increased stress and moral injury among healthcare workers. Fear and guilt combined to damage mental health. This proves the need for specific therapy strategies (). Counselors must address shame, guilt, and fear. This work supports successful trauma counseling.(Barakat S et al., 2023) highlights how experiences of abuse and trauma are closely linked to maladaptive emotional responses, which can hinder effective treatment approaches. Additionally, during crises like the COVID-19 pandemic, the heightened stress and moral injuries experienced by healthcare workers illustrate how fear and guilt can aggregate, negatively impacting mental health.
Please also review AIHCP’s Trauma Informed Care Program as well as its various Healthcare Certification Programs
Trauma is a reaction to distressing events that overwhelm a person’s ability to cope. It leads to lasting psychological effects. These effects appear as anxiety, depression, and changes in self-perception. Shame and guilt often shape these changes. People may struggle with feelings of worthlessness and self-blame. Fear from the trauma makes these feelings worse. For instance, aspects of trauma from childhood experiences and abuse highlight compounding effects. These effects influence mental health over a lifetime. This connection is important for understanding therapeutic needs (). Stressors from events like the COVID-19 pandemic also increased existing vulnerabilities. They show how widespread fear intensifies psychological distress in these groups (). These facts show the need for trauma-informed counseling methods that address these emotional complexities.(Barakat S et al., 2023)). Furthermore, the unprecedented stressors related to events like the COVID-19 pandemic have magnified existing vulnerabilities, revealing how widespread fear can intensify psychological distress in affected populations ((Kontoangelos K et al., 2020)). Such insights underscore the need for trauma-informed counseling approaches that address these emotional intricacies.
Counselors must understand the complex emotions of shame, guilt, and fear. Each emotion affects an individual’s psychological well-being. Shame often comes from a perceived failure to meet personal or societal standards. This leads to feelings of worthlessness. Guilt typically comes from specific actions or inactions that violate a moral code. It causes regret and self-blame. Fear acts as a reaction to the threat of emotional or physical harm. It often worsens shame and guilt. These emotions can mix together in counseling. Counselors must help clients untangle them and deal with each one. Research shows that mindfulness and compassion-focused methods reduce the force of these emotions. These tools build psychological resilience and help healing. Therapists must develop methods to work with these complex feelings.(Conversano C et al., 2020). Therefore, its crucial to develop therapeutic strategies that specifically engage with these complex emotional landscapes (Maben J et al., 2020).
Trauma counseling helps individuals manage the emotions caused by their experiences. It addresses feelings of shame, guilt, and fear. These emotions hurt mental health. They increase distress and lead to harmful coping habits. Counselors discuss these feelings in therapy to create validation and understanding. Then the client can heal. Research shows a strong link between trauma and issues like anxiety and depression. This proves that proper treatment is necessary. For example, knowing the complex nature of shame and guilt shapes specific treatments. These approaches reduce symptoms and help clients build resilience. Strategies that reduce fear can restore a sense of safety. This improves the success of trauma counseling.(Barakat S et al., 2023). Moreover, strategies aiming to alleviate fear can help restore a sense of safety, thereby enhancing the overall efficacy of trauma counseling (Lene E Søvold et al., 2021).
Shame blocks healing during trauma counseling, and it harms the relationship between therapist and client. Survivors of trauma often feel ashamed about the events they lived through. This feeling increases their distress and stops them from speaking openly in therapy. This barrier starts a cycle where shame adds to guilt and fear. Then the healing process becomes much harder. Counselors must understand these effects because shame changes how clients see their worth and control. It also affects their choice to get help. Counselors treat shame with compassion and empathy to cause real change. Clients can then face their trauma and move toward recovery. This approach helps people facing high stress in crisis situations, as highlighted by reports and studies.(Lene E Søvold et al., 2021) and (Kontoangelos K et al., 2020).
Shame has deep psychological effects on trauma survivors. It often shows up as harmful self-views that block recovery. Survivors often feel unworthy. They believe they deserved the abuse. This belief keeps a cycle of guilt and self-blame alive. These thoughts cause severe emotional results like depression and anxiety. Survivors then find it hard to build healthy relationships or ask for help. Abuse within institutions makes these feelings worse. Survivors face personal trauma alongside systemic neglect. They face betrayal from systems that were meant to protect them. Studies show that survivors of institutional abuse report deep shame about being victims. This shame makes healing harder. It also limits their ability to speak up for themselves. Addressing these feelings in counseling helps people reclaim their identity. It builds resilience. This process proves the key role of shame in recovery.(Filistrucchi P et al., 2023)(Kontoangelos K et al., 2020).
Shame often blocks individuals from finding help and healing after trauma. This emotion comes from a deep belief that one is flawed or unworthy. People hesitate to share their stories or vulnerabilities. Many victims struggle with the stigma of their experiences. Male sexual assault survivors often face this challenge. They believe harmful myths that cause silence and isolation. These barriers increase guilt and fear. Then, finding support becomes harder. New approaches like the Psychedelic Harm Reduction and Integration (PHRI) model focus on removing stigma in therapy. This model uses empathy and acceptance. It encourages openness instead of shame. This change is needed to remove barriers. It builds a better space for trauma recovery.(John C Thomas et al., 2023). Such barriers reinforce feelings of guilt and fear, leading to a compounded struggle in seeking necessary support. Furthermore, innovative frameworks like the Psychedelic Harm Reduction and Integration (PHRI) model highlight the importance of destigmatization in therapeutic settings, advocating for an empathetic and accepting approach that encourages openness rather than shame (Gorman I et al., 2021). This shift is essential for dismantling barriers and fostering a more supportive environment for trauma recovery.
Trauma counselors must address shame. It often mixes with guilt and fear and stops healing. Therapies like Cognitive Behavioral Therapy (CBT) help people change negative thoughts linked to shame. Mindfulness practices also work well. Recent books show they build self-compassion and reduce feelings of inferiority. These techniques improve self-awareness and control over emotions. They support trauma recovery and resilience in clients . Compassion-focused therapy (CFT) teaches self-kindness and helps people see their worth. This matters for clients fighting deep shame. Counselors use these methods together to create a safe space. Clients then face their shame and other emotions. This aids the full process of trauma recovery ..(Conversano C et al., 2020). Furthermore, compassion-focused therapy (CFT) focuses on developing self-kindness and recognizing ones worth, which is essential for clients grappling with deep-seated shame. By integrating these therapeutic modalities, counselors can create a safe environment that encourages clients to confront and process their shame, among other emotions, thereby promoting a more holistic approach to trauma recovery (Maben J et al., 2020).
Guilt is a complex emotion in trauma recovery. It influences the healing process. Individuals often feel guilt related to their trauma. This burden complicates their emotions and slows progress. For instance, some feel guilty about perceived failures during traumatic events. They struggle to accept their circumstances. This delays recovery. This state leads to strong shame. Individuals fight against self-blame and negative self-judgment. Research shows that addressing guilt in counseling is necessary. It aids emotional release and builds resilience. Therapy methods that encourage self-forgiveness improve mental health. They help individuals handle their feelings better. Counselors must understand the link between guilt and the lasting results of trauma. This knowledge helps them provide specific support. Clients can then own their stories and continue their recovery.(Lene E Søvold et al., 2021)(Ramaci T et al., 2020).
Trauma counselors must understand the difference between healthy and toxic guilt. Each type affects mental well-being in a distinct way. Healthy guilt acts as a moral compass. It helps people realize when they hurt others. This feeling builds empathy and accountability. Toxic guilt is different. It is a draining emotion. It often comes from impossible standards or inner criticism. This leads to feelings of shame and worthlessness. This harmful guilt stops recovery and personal growth. It traps trauma clients in loops of self-blame. Treatments that build self-compassion play a key role in reducing toxic guilt. This allows people to create a supportive inner dialogue. It lowers the sense of threat connected to this emotion. Counselors separate these two types of guilt. They adjust their methods to help clients react with healthier emotions.(Neuenschwander R et al., 2024). By differentiating between these two types of guilt, trauma counselors can tailor their approaches to foster healthier emotional responses in their clients (Maben J et al., 2024).
Guilt deeply affects self-esteem and recovery in trauma counseling. People struggle with these feelings and often feel worthless. This lowers their self-esteem and motivation to recover. This cycle causes ongoing psychological distress. It becomes hard for individuals to focus on healing. Research shows that unresolved guilt harms mental health. It can worsen trauma symptoms and stop progress in therapy. The heavy weight of guilt also leads to social isolation. People pull away from supportive relationships. This adds to their shame and despair. Effective trauma counseling must address these emotions. It should teach self-compassion and change how patients view guilt. This helps people recover and improve their self-worth.(Barakat S et al., 2023). Furthermore, the emotional burden of guilt often results in social isolation, as individuals withdraw from supportive relationships, compounding their feelings of shame and despair (Andra Cătălina Roșca et al., 2021). Effective trauma counseling must, therefore, address these emotions, fostering self-compassion and reframing guilt, which can empower individuals on their journey toward recovery and improved self-worth.
Trauma counselors help clients process guilt for emotional healing. One method is creating a safe environment. Clients discuss guilt there without judgment. They explore the origins of the feeling. They see how it affects their lives and relationships. Counselors also use cognitive-behavioral tools. These challenge negative thoughts. Clients change their stories and separate guilt from shame. Group therapy shares these experiences. Clients feel less alone. Programs like Before Operational Stress (BOS) show that early action builds resilience. These programs support healthy relationships. This shows we must address guilt in a structured way.(Rokach A et al., 2023) (Andrea M Stelnicki et al., 2021).
Fear acts as a barrier and a catalyst in trauma counseling. Clients enter counseling with fear from past traumas. It hinders their ability to talk openly and honestly with the counselor. This hesitation blocks the healing process. The COVID-19 pandemic makes this reaction worse. Individuals feel overwhelming stress and anxiety. This is especially true for vulnerable populations, and it makes existing fears stronger. Healthcare workers also face high levels of fear and anxiety. They often struggle with moral injury and burnout from the pressures of their roles. This complicates their mental health. Counselors must address these fears. They have to create a safe and supportive environment. This encourages clients to confront their fears. Doing so leads to recovery and resilience in the face of trauma.(Lene E Søvold et al., 2021). Furthermore, healthcare workers, who also face heightened levels of fear and anxiety, often struggle with moral injury and burnout due to the pressures of their roles, complicating their mental health (Kontoangelos K et al., 2020). Consequently, addressing these fears within the counseling framework becomes essential; counselors must create a safe and supportive environment that encourages clients to confront their fears, ultimately facilitating recovery and resilience in the face of trauma.
Fear often stands out as a main emotional response in people who have lived through trauma. It serves as a psychological defense. But it also acts as a big block to healing. This wide-reaching emotion appears in many places. It affects vulnerable groups heavily. Healthcare workers dealing with crises like the COVID-19 pandemic are a clear example. Reports show that fear, anxiety, and stress surged among these workers. These feelings worsen challenges like burnout and moral injury. Such problems make it difficult to cope with the results of traumatic experiences. The pandemic raised fear levels in medical professionals. It also impacted children and older adults. It made them feel unsafe and led to deep psychological effects. Trauma counseling must view fear as a standard response. Treating this emotion helps patients build resilience and recover.(Lene E Søvold et al., 2021). Furthermore, the pandemic has not only heightened fear among healthcare professionals but has also impacted children and older adults, instilling a sense of vulnerability that leads to profound psychological effects (Kontoangelos K et al., 2020). Recognizing fear as a common response to trauma is essential for trauma counseling, as addressing this emotion is crucial for promoting resilience and facilitating recovery.
Fear plays a large part in avoidance behaviors. This is true in trauma counseling. Fear acts as a defense against perceived threats. Survivors of traumatic events often use avoidance. They do this to reduce the fear and anxiety linked to reminders of their trauma. This reaction appears in the demographic trends of eating disorders. Emotional pain from trauma leads people to avoid specific situations. They shun triggers that spark negative emotions or memories. Fear continues to guide these patterns. It worsens feelings of isolation and discomfort. Then the cycle of harmful coping strategies repeats itself. Counselors must address fear to stop this avoidance loop. This work builds better coping mechanisms. The process helps the patient recover and gain resilience.(Barakat S et al., 2023). Furthermore, as fear continues to influence these avoidance patterns, it can exacerbate feelings of isolation and discomfort, thus perpetuating a cycle of maladaptive coping strategies (Hay P, 2020). Consequently, addressing fear in trauma counseling is essential for breaking the cycle of avoidance and fostering healthier coping mechanisms, ultimately promoting recovery and resilience.
Counselors must manage fear to build a safe space for healing. One common technique is mindfulness-based stress reduction (MBSR). It encourages clients to notice thoughts and feelings without judgment. This practice eases anxiety and builds self-compassion. Individuals can then face fears in a supportive setting. Practitioners also use cognitive-behavioral strategies. These help clients change negative thought patterns linked to trauma. The change reduces the strength of fear responses. Grounding techniques like deep breathing give clients control. They help people stay present during distressing moments. The mental health crisis shows the value of these approaches. Events like the COVID-19 pandemic made the crisis worse. Structured plans are now important for clients and professionals.(Conversano C et al., 2020). Moreover, practitioners can integrate cognitive-behavioral strategies that help clients reframe negative thought patterns associated with trauma, thereby reducing the intensity of fear responses. Creating grounding techniques, such as deep breathing exercises, further empowers clients to maintain presence and control during distressing moments. As the ongoing mental health crisis, exacerbated by events like the COVID-19 pandemic, underscores the importance of these approaches, integrating structured interventions becomes increasingly vital for both clients and healthcare professionals (Lene E Søvold et al., 2021).
Trauma counseling must address shame, guilt, and fear. These emotions mix together and shape the healing process for survivors. They often stop people from speaking and keep them isolated. Survivors struggle with the belief that their pain is shameful or undeserved. Stories from participatory research show that we must acknowledge these feelings. Doing so builds strength and helps victims of institutional abuse recover . We also need to understand the emotional work people do, such as coping with phantom limb sensations after an amputation. This example highlights the many sides of trauma and how it appears . Counselors can focus therapy on these emotions to create a safe place. Survivors then feel able to voice their experiences. This leads to progress and shared healing.(Filistrucchi P et al., 2023). Furthermore, understanding the emotional balancing acts individuals undertake, such as coping with phantom limb sensations post-amputation, underlines the multifaceted nature of trauma and its manifestations (Andra Cătălina Roșca et al., 2021). By centering therapy around these emotions, counselors can create a safe environment where survivors feel empowered to voice their experiences, ultimately paving the way for therapeutic progress and communal healing.g
Shame, guilt, and fear are major factors in trauma counseling. They affect a client’s mind and ability to heal. Shame usually comes from a sense of worthlessness. It can block recovery by creating isolation and self-blame. Guilt often comes from the belief that one failed to protect themselves or others. This worsens trauma symptoms and slows progress in therapy. Fear links to past traumas and causes strong anxiety. This makes it hard for people to face their experiences or participate in therapy. Therapists must recognize these complex emotions. They are important because they can stop recovery or help it. These emotions get stronger during a crisis like the COVID-19 pandemic. This proves the need for trauma-informed care that treats such feelings well.(Lene E Søvold et al., 2021)(Kontoangelos K et al., 2020).
Emotional awareness is key in the therapeutic process. It helps in trauma counseling because feelings of shame, guilt, and fear often block healing. Therapists use this awareness to help clients name their emotions. This leads to a clear understanding of their trauma. This awareness helps clients face hard feelings. It also builds self-acceptance and strength against adversity. Research shows that shame and guilt worsen mental health issues. They cause a cycle of avoidance and distress. But building emotional awareness reduces these problems. Clients can view their experiences differently in a helpful environment. So, focusing on emotional awareness helps individuals manage their trauma. It encourages useful coping methods. The result is better mental well-being.(Barakat S et al., 2023). In contrast, cultivating emotional awareness mitigates these issues by allowing clients to reframe their experiences and emotions in a supportive environment. Consequently, prioritizing emotional awareness in therapy not only empowers individuals to navigate their trauma but also encourages the development of adaptive coping strategies, ultimately leading to enhanced mental well-being (Lene E Søvold et al., 2021).
Trauma counseling is changing. Future research and practice must focus on understanding the mix of shame, guilt, and fear. We must add to current writings to build specific treatment plans. These plans must directly treat the emotional responses in trauma survivors. Recent findings connect childhood experiences and personality traits to trauma symptoms. These factors play a large role. This shows a need for personalized therapy. Qualitative studies also suggest that emotional balancing helps people feel normal again. It could serve as a base for new counseling models. Researchers and practitioners can study these areas to improve current methods. They can create evidence-based plans that help survivors heal. This work will improve mental health results for many groups.(Barakat S et al., 2023). Moreover, qualitative studies suggest that emotional balancing is essential for individuals striving to regain normalcy after trauma, which could serve as a foundational element for new counseling frameworks (Andra Cătălina Roșca et al., 2021). By exploring these dimensions, researchers and practitioners can enhance existing methodologies and create more effective, evidence-based strategies that foster resilience and healing among trauma-affected individuals, ultimately improving mental health outcomes in diverse populations.
Please also review AIHCP’s Trauma Informed Care Certification as well as AIHCP’s numerous other healthcare certifications
APA. (2025). “How to cope with traumatic stress”. Access here
Herzberg, B. (2025). “The Differences Between Guilt and Shame”. Psychology Today. Access here
“Guilt as part of PTSD; and ways to dismantle it”. PTSDuk. Access here
Gillette, H. (2024). “What’s the Relationship Between Trauma and Anxiety?”. Healthline. Access here
Abuse can easily occur when authority is not monitored. This happens at every level of human experience, whether through physical or emotional abuse or sexual abuse but also in regards to corruption
Please also review AIHCP’s Trauma Informed Care program and other healthcare certifications
It is a grave and immense responsibility of counselors to protect their clients when imminent harm to themselves, others or abuse is reported. Confidentiality has its limitations in these cases and a legal obligation to report becomes necessary. This video looks at signs of imminent harm as well as how to help clients understand the need to submit to the safest decisions that may include temporary mental ward observation or reporting an abuser.
Please also review AIHCP’s Healthcare Certifications as well as AIHCP’s Trauma Informed Care Certification
The most common trait we think of when discussing PTSD is dissociation. Whether through flashbacks, or disconnections from the present, dissociation primarily seen as a pathological left over from a traumatic event, most seen with combat veterans. Within this imagery, one sees a firecracker or backfire from a car that sends a military veteran into a flashback of a past war scene. While this is accurately captures PTSD, this is only one minor aspect of dissociation and only illustrates its pathological symptoms instead of its overall necessity within the protective and defense mechanisms of the human body against extrema trauma. It is important to remember according to Contreras, that some dissociative behaviors are also part of the human experience and not necessarily pathological symptoms (2024, P, 181). In this blog, we will shortly look at dissociation in a broader scope and see how it exists not only during the trauma, but after the trauma as well, and how it manifests in multiple different ways.
Please also review AIHCP’s Healthcare certifications, especially AIHCP’s Trauma Informed Care and Spiritual Trauma Informed Care programs.
During extreme stress or trauma, or life or death situations, the body’s autonomic nervous system responds through its sympathetic or parasympathetic branches. As discussed in previous blogs, this can lead to fight, flight, freeze, fawn, or even fade. Since dissociation deals with fade or immobility, it is part of the parasympathetic response during a traumatic event. In its peritraumatic state, the survival mechanism is natural and looks to help the person disconnect, detach, or compartmentalize the event. This is shutdown is is to spare the mind the horrible nature of the event and other emotional and mental damages, albeit, it also shuts the person’s physical abilities to continue resistance. During this moment of detachment, the Prefrontal Cortex’s emotional processing is inhibited and the sympathetic activity is reduced. In turn, the parasympathetic response increases and the activity of the cortico limbic brain creates algesics to skip the process of storing memories, or recalling memories, especially painful ones. In addition, analgesics are produced to reduce pain and numb the body from the event (Contreras, 2024, p. 176-177). This process can leave gaps in memory as well as other cognitive and emotional related issues. The more traumatic event, the more traumatic the dissociation and due to this the higher possibility to dissociate later (Contreras, 2024, p. 173).
What to remember is this natural defense and survival response is normal in its hope of protecting the mind and body.
Dissociation becomes pathological when it continues to haunt the mind after the actual event. The mind can be easily triggered due to similar scents, surroundings or signs that evoke the survival response. For many, they are already existing in a constant survival strategy mode, keeping systems on red alert. Within dissociation, individuals may experience psychological and functional alterations of memory and identity. Others may sense physiological symptoms such as temperature loss in the limbs, or a lowered heart rate. Others may sense a detachment from surroundings or disconnect from bodily sensations. Others may experience less pathological experiences with temporary states of day dreaming or disengagement with life (Contreras, 2024, p. 174). Various aspects are also affected by dissociation such as loss of time, disconnect from body, disconnect from identity of self, lack of motivation, amnesia and memory loss, or loss of capacity to recognize emotions and their affect, meaning and range (Contreras, 2024, p. 175). All of these issues represent true significant issues for a person who has not returned to homostatis or baseline due to the traumatic event. Since the body remains in a state of survival mode, mechanisms that are meant to be temporary instead are becoming permanent states of being for the individual.
Dissociation can become especially dangerous when in its extreme form it can cause individuals to become invert and thoughtless to their surroundings or what is happening. When amnesia is present, it can disconnect a person from their true self which forces the person to create new schemas or behaviors that are extreme in nature (Contreras, 2024, p, 182).
Dissociation according to the DSM-5 can also be experienced as a DPDR disorder (Depersonalization-Derealization disorder), as a Dissociative Identity disorder (multiple personality) or a amnesia based disorder. Due to these more extreme cases, it is critical to find help if these issues grow worst or persist. With personalization, the person feels detached, or even as an outside observer of one’s mental processes. With derealization where one experiences a type of unreality about one’s surroundings, as if dreamlike, distant or distorted (Contreras, 2024, p,. 319).
Therapists, especially those trained in trauma informed care, are especially equipped to help a person again find baseline or homostasis. They can help the individual again deactivate the autonomous nervous system and turn off survival mechanisms that have hijacked the overall person’s life. This involves not only learning to regulate emotions, but also instructing others in grounding techniques that can limit the dissociation. In many cases, exposure therapy and reframing is necessary to help the person move beyond the traumatic event. It involves helping the brain properly store the memory and process it. In doing so, the brain can eventually reset without being alerted to non threats.
Please also review AIHCP’s blog on grounding techniques for those suffering from PTSD. Click here
Dissociation is a natural response of the parasympathetic nervous system that involves detachment during a traumatic event. It shuts down many centers of the brain for memory by effecting encoding , storage and retrieval. Instead the memory becomes emotional and tied to the amygdala. Additionally, the hippocampus has a difficult time differentiating the past memory and event with the present moment and associates everything as imminent. This in turn leads to triggers and continued detachment from non existent threats. Since the body remains in a state of red alert, dissociation as a survival mechanism instead becomes a survival strategy that persists until the person is finally able to resolve the past trauma.
Please also review AIHCP’s healthcare certifications as well as its Trauma Informed Care and Spiritual Trauma Informed Care programs.
Contreras, A (2024). “Traumatization and Its Aftermath: A Sympathetic Approach to Understanding and Treating Trauma Disorders”
Tull, M. (2025). “What Is Dissociation?. Very Well Mind. Access here
“Dissociation”. Psychology Today. Access here
“Dissociative Disorders”. Mayo Clinic. Access here
Guy Evans, O. (2025). “What Is Dissociation? Types, Causes, Symptoms & Treatment”. Simply Psychology. Access here
Abuse has many faces. It can be physical, it can be sexual and it also can be emotional. Prolonged emotional abuse which is chronic overtime chips away at the person and places him or her into a state of constant survival. Instead of stress responses acting as responses in the moment to survive, they become a constant state of existence. This is one of the primary differences between PTSD and C-PTSD. Under long periods of repeated duress due to emotional abuse or even neglect, the brain rewires itself to exist within a survival state. With no acute emotional wound but a collection and series of events, emotional abuse or any type of abuse that is chronic or repeated, becomes difficult to discern what started ignition from survival response to survival state itself. The delicate balance of allstasis or the ability to remain stable adjusts to constant change eventually reaches a state of allostatic load that eventually can crash in which the survival state becomes a new state that overtakes the person.
Please also review AIHCP’s Trauma Informed Care Program as well as AIHCP’s numerous behavioral healthcare certifications
Emotional abuse is a trauma overtime that can lead to a survival state due to the repeated abuse or neglect. Around 80 percent of all maltreatment of children can be reduced to emotional abuse and neglect. While these things do not necessarily require physical or sexual abuse, they gradually wear the person down. This is especially true of children with developing brains that can be hindered by chronic emotional abuse or neglect.
According to Contreras, neglect as a type of abuse categorized as omission (2024, p. 183). With neglect and emotional abuse, the child or even person enters into a state of survival mode. One is on red alert constantly for what may go wrong in a particular day due neglect or emotional abuse. When those limits are met, just like any stress, the person is able to adjust or lose ability to cope and falls victim to the stressor, trauma or abuse. These individuals will have emotional regulation issues, hyper or hypo arousal states, and react to the abuse in different ways according to these states. Individuals under constant barrage can fall into fight, flight, fawn or fade as the daily barrage of abuse or neglect degrades their personhood, identity and mood. In these cases to survive the prolonged neglect and abuse, the person appeases, becomes aggressive with others, looks to escape confrontations, look to please, or fade into thinking there is no true abuse (Contreras, 2014, p. 201-202). From this, neglect and emotional abuse drains the person of self, identity and self worth, replacing daily actions into survival responses adapted for prolonged exposure to the stressors or minor traumas of the day. It is because of this that many who have gone through such abuse or neglect, develop C-PTSD.
Neglect to basic needs, both physical and mental are detrimental to children and their development into mentally stable adults. Neglect and emotional abuse not only hurts the development of the brain but also can lead to physical ailments due to the constant state of survival.
Chronic emotional abuse according to Contreras is any words or non physical actions that hurt, belittle, weaken, manipulate or frightens a person. In addition the abuse causes distortion and confusion that shakes the person’s very stability in life. Many forms of mental abuse are carried on through neglect, but also intimidation, manipulation, objectification, gaslighting, yelling, and even obsessive jealousy (2024, p. 184). Individuals are left with exhaustion, depression, low self esteem, and feel trapped. In doing so they look for maladaptive ways to cope with trauma. Many times, especially children, but also adults, can become stuck in a co-dependent relationship which are detrimental to all levels of their existence. While the person is not in a life or death situation, the person does develop a shattered sense of self. This is accomplished through mind games, devaluation, and scheming that mentally undermines the person. Contreras lists manipulation, gaslighting and objectification as key ways of controlling and harming the person (2024, p. 187-189).
Manipulation
Contreras defines manipulation as a type of subtle abuse to debilitate a person’s will and capabilities to obtain personal gain, control, submission, obedience and pleasure from the abused (2024, p. 187). Individuals who are constantly manipulated lose sense of self, and self esteem leading them to feel used, depressed and hopeless. If they do not respond to the manipulation, many emotionally and neglected fear abandonment and rejection from the abuser.
Gaslighting
According to Contreras, gaslighting is an effective for abusers to control and manipulate their victim. They do so by making the individual doubt his or her own reality making the person feel crazy or insecure (2024, p. 188). It intentional to control the person and keep them within the abuser’s web of chaos.
Objectifying
In many cases, those who are emotionally abused, as well as physical, are objectified as property. The person loses autonomy of self. Contreras lists a variety of ways objectification occurs. Instrumentality refers to using the person as a tool to meet an end or satisfy one’s own goals. Denial of autonomy refers to the inability for the person to act on his or her own without consent from the abuser. Ownership refers to a person’s literal autonomy belonging to the abuser to be used and sold as the abuser sees fit. Denial of subjectivity dismisses the abused and his or her experiences or feelings as not worthy of attention or need. Finally silencing refers to taking away the person’s voice (Contreras, 2024, p. 190-191).
Individuals who objectify other human beings in general lack any form of empathy, are ego-centric, and put their needs and goals over everyone. They are usually tied to the personality disorder of narcissism (Contreras, 2024, p. 189).
Unfortunately, this leads to trauma bonding which according to Contreras, leads the abused to an attachment with the abuser that disempowers the individual into a perpetual state of defeat under the mirage of being loved (2024, p. 192).
Severe neglect, as well as emotional abuse is a different wound than physical wounds. They may not inflict immediate death or harm but they lead to a chronic breaking of the spirit and the person’s development. It leads to a host of emotional and mental problems that destroy the mind and soul. Due to its usual chronic state and repeated offenses, it wears the person down and can manifest in states of C–PTSD where the person enters into a constant survival state that breaks down not only the mind but the body. It steals the joy of life and the dreams of others.
Please also review AIHCP’s Trauma Informed Care Certification as well as AIHCP’s Healthcare Certifications
PTSD vs C-PTSD. Click here
Contreras, A. (2024). Traumatization and Its Aftermath: A Systematic Approach to Understanding and Treating Trauma Disorders”
Valdez, R. (2025). “Signs of Emotional Abuse”. VeryWellMind. Access here
Pietrangelo, A. & Raypole, C. (2025). “How to Recognize the Signs of Emotional Abuse”. Healthline. Access here
“Emotional Abuse”. Psychology Today. Access here
“What Is Emotional Abuse”. National Domestic Violence Hotline. Access here
Trauma survivors and victims of past abuse are more easily preyed upon by abusers. It is important to identify past victims and help grow in healing to repel future attacks from predators. This video takes a closer look at this process and how to help victims remain safe
Please also review AIHCP’s Trauma Informed Care Program as well as its healthcare certification programs
Helping clients regulate their emotion during counseling is critical in helping them heal. This video looks at a variety of grounding techniques.
Please also review AIHCP’s TRAUMA INFORMED CARE CERTIFICATION as well as its SPIRITUAL TRAUMA INFORMED CARE PROGRAM. AIHCP offers a variety of healthcare certifications to review. Please click here