Empathy & Trauma
If you’re in the empathy business, then learning about trauma and how to empathize with people who’ve experienced trauma is incredibly important because it’s the most human thing we can do.
And guess what — everyone is in the empathy business. Why? Because you are a human being.
Empathy is the action of understanding, connecting, and relating to someone else's emotion. Emotion is the most biological and primitive part of the human brain (limbic system). Without emotions, we would not be able to survive.
How do you empathize with people who have experienced trauma (or some form of extreme/prolonged anxiety, stress, fear, worry)? Let’s start from the beginning.
Why is trauma created?
Trauma is created when the body fails to eliminate stress hormones over a prolonged duration of time.
The prolonged duration of time is subjective for each person. It could be seconds or it could be years. Science cannot instantaneously tell when trauma is created like the flip of a switch nor can science measure when a traumatic experience is formed — however, it can be studied through reenactments (retelling a story and monitoring the brain).
The basic function of stress hormones is to mobilize the body. So what happens when your stress hormones fail to mobilize the body? Trauma.
What you need to know about memory and trauma
There are two main parts of long-term memory: Explicit and Implicit. See the memory tree below.
The area of the brain’s memory focused on empathy and trauma comes from the implicit form of long-term memory: procedural and emotional conditioning.
Implicit memory is memory humans cannot deliberately call up to the conscious mind. As opposed to recalling facts or experiences you’ve had in your past, implicit memory is non-declarative, or subconsciously programmed.
The emotional memory is responsible for…storing emotions. The function of emotional memory is to encode and attach emotions to certain experiences and use this programming for future reference.
Emotional memories are experienced in the body as physical sensations. These memories operate on the deepest levels of our subconscious and are triggered by present experiences. Our emotional memories communicate with our procedural memory and evoke certain actions.
However, when emotional memories incorrectly or mal-adaptively evoke a negative procedural memory — trauma can be created in procedural memory.
Procedural memories is the ‘how’ or the physical responses to the emotion experienced. The procedural memory of the brain has 3 categories:
- Learned motor actions (dancing, riding a bike, sex)
- Emergency responses (fight, flight, freeze)
- Organismic responses (approach, avoidance)
It’s due to the failed actions from our procedural memory that can cause the creation of traumatic memory.
How is trauma created?
As you learned in the previous section, our procedural memory is responsible for physical responses to emotional experiences.
The emotional memory and experiences start in the limbic brain. At the center of the limbic brain, sits the amygdala. The amygdala is the “smoke detector” of the human body — identifying any danger and significance of all the sensory inputs (sight, smell, sound, etc) that the Thalamus absorbs. There are 3 chronological stages to the formation of trauma.
Stage 1: Fight or Flight
When your amygdala identifies a significant emotional threat, the autonomic (sympathetic) nervous system or SNS is activated. Instantaneously, the Hypothalamus then secretes stress hormones (adrenaline, cortisol, and or norepinephrine) into the body. At this moment, the SNS activates the muscles, heart, and lungs.
Going back to the why is trauma created, deep within our procedural memories, their job is to evoke physical action in order to eliminate these stress hormones. The first set of actions at the beginning of trauma is fight or flight.
Stage 2: Freeze
When fight or flight fails or when your procedural memory and SNS fail to mobilize your body to eliminate the stress hormones, your body moves into the next stage of forming trauma: freeze.
Stage 3: Fold (Collapse)
When your SNS fails to eliminate the stress hormones under the action of freezing, then the final stage occurs — which is folding. In this stage, you are in complete helplessness and hopelessness.
Stage 3 marks the final stage and creates the formation of what will be known as a traumatic memory.
During folding, the amygdala is no longer in control. The reptilian brain inside the brain stem is now activating a complete shutdown. During a shutdown, your body is simultaneously at the speed of light* alternating between both parts of the autonomic nervous system: parasympathetic (PNS) and sympathetic (SNS).
It is during this stage that the prolonged duration of time creates an official traumatic experience. Stress hormones are still present.
Loss of Self
In the moment and experience of a traumatic event (stage 3):
“We cease to matter. Awareness is shut down, and we may no longer even register physical pain.” — Dr Bessel Van Der Kolk
Take a moment to understand this grave truth.
When awareness ceases to exist, the Self no longer exists. When the Self no longer exists, you do not exist.
Instantaneous nonexistence is the essence of the formation of trauma. Trauma is so serious that it takes you out of existence.
Now, empathize with that.
OK. So, what are traumatic memories?
Now that you know why and how trauma is formed in our brain, body, and memory systems — it is time to move into the present moment.
Empathizing with someone with a history of trauma requires an understanding that even though the trauma happened in the past — the memory of the traumatic experience does not necessarily live in the past.
Yes, it is a memory. But what kind of memory?
Normal memories (good and bad) are mutable, dynamic, and ever-changing over time. However:
“Traumatic memories are fixed and static. They are imprints from past overwhelming experiences, deep impressions carved into the sufferer's brain, body, and psyche.” — Peter Levine
Why are they fixed and static?
During the explanation of how trauma is formed, I mentioned how the emotional part of the brain and SNS take over to eliminate stress hormones. The more adrenalin you secrete, the more precise your memory will be. However, there is a tipping point where your memory system shuts down.
In these moments (stages 1–3), other parts of the brain are shut down. Specifically, the Hippocampus. The Hippocampus’s function is to create a story or narrative of an experience rooted in a timeline with a beginning, middle, and end. It uses imagery, sound, smell, feel, sight, kinesthetics, and other sensory inputs to form a normal memory.
However, when the Hippocampus is off or disconnected from the rest of the brain during the formation of trauma — all you are left with is fragments. All the sensory inputs are isolated. This is why people with trauma can be triggered by random things (noise, sight, smell, etc).
Without the Hippocampus, memories do not live in a single moment in time. Until the fragments can be pieced together using the hippocampus, traumatic memories are frozen or lost in time.
As procedural and emotional memory are responsible for the creation of trauma in our mind and body, they are also the systems responsible for healing and eliminating trauma — letting trauma just become another ordinary memory in past.
Moving the fragmented traumatic memory from procedural to episodic (explicit) memory and integrating the memory with the rest of the brain is one of the keys to healing trauma.
Again, I want to take a second so you understand this grave truth.
Traumatic memories do not have a sense of time, yet traumatic memories are healed once they are given a timeline — healing trauma is about moving the traumatic memory through time (an event with a beginning, middle, and end) just like a normal (episodic) memory.
People who live with trauma have a deep part of themselves who are anchored to the past, yet do not have a sense of agency to where trauma lives in time.
Now, empathize with someone who feels frozen in time, yet lives timelessly not knowing when they may be triggered in the future.
Where Does Trauma Live?
Trauma starts in the brain and lives in the brain as we established earlier. The emotional and procedural brain (and memory systems) are responsible for the formation and storage of trauma. The fragmentation of traumatic memory lives scattered in different parts of the brain.
During the 3 formation stages of trauma, the autonomic nervous system (ANS) living in the brain stem uses the nerve system: “Ventral Vagus Complex” to communicate with the body’s organs. See below.
This explains why you feel like your heart is collapsing during fight or flight. The fragmented traumatic memories discussed earlier are also fragmented body sensations. Traumatic memories are encoded in the visceral, gut-wrenching emotions of the mind, brain, and body.
It starts with understanding
“For our physiology to calm down, heal, and grow we need a visceral feeling of safety.” — Dr Bessel Van Der Kolk
The feeling of safety is quite complex. However, there is a simple truth about all human beings — we all want to feel seen, heard, and understood.
So start by just acknowledging how people are living with trauma. Understand that the anxiety or stress you see on the surface may live a whole lot deeper. Before you empathize, you must understand. Use this sense of understanding as a foundation of your intentions to empathize with people.
By empathizing with people who have experienced trauma, you can most certainly empathize with the emotions of stress, anxiety, fear, and worry. Why? Because during these emotions, our brain also secretes stress hormones.
It starts with stress. It ends with trauma.
How to empathize with people
I do not want to complicate empathy, so I am going to break down how psychologists Daniel Goleman and Paul Ekman conceptualize empathy. I like their model — it’s simple.
They say there are three types of empathy: cognitive, emotional, and compassionate empathy.
However, I take their three types of empathy and rename them into words I associate within my personal empathy practice.
Stage 1: Curiosity (cognitive empathy)
The first stage of practicing empathy starts with curiosity.
Start by being curious with the intention to understand. Be curious about the experience or current emotion.
Start with being curious about what emotion is most present. Is this person feeling anxious? Fearful? Worrisome? Upset? Sad? Scared? Try to interpret their body language, speech patterns, behavior, and mood. Do everything you can to remove any biases you may attribute to their emotion. Often times, someone with a history of trauma or prolonged stress has one emotion that is surfacing the strongest. This is the emotion in which you connect to in stage 2.
Increase your awareness and sensitivity to seeing anxiety and stress. Now that you’ve learned about trauma, be on the curiosity train that someone may be living a certain way that deserves empathy.
Instead of being frustrated with a coworker or employee who is not able to do their work because they are stressed all the time, take a mindful moment to acknowledge that this is a time to be curious.
Instead of being anxious at your loved one for being fearful about your actions, be curious about the root cause of these emotions.
Before we connect with someone else’s emotions, we must understand them. We must understand an emotion not so we can think about an experience similar to their’s, but it’s more about understanding an emotion so you know which one to relate your own feelings to.
Stage 2: Connection (emotional empathy)
Once there is a certain level of understanding, start connecting via emotional empathy.
In stage 2, the goal is to connect to their emotion or feeling that you were curious about in stage 1. Connecting with someone’s stress or anxiety requires patience. Before sharing your personal experiences of a possible similar feeling, listen to them.
Find a place of certainty within your own body that feels like a strong emotional connection. Try to find a time in your past that connects to their emotional pain, anxiety, stress, or fear.
Connection is about relating to their feelings by being able to create/imagine the same emotion in your body. Once a connection is made, you now can serve them.
Stage 3: Service (compassionate empathy)
The last stage of empathy is service. In this form of compassionate empathy, service requires us to take action.
Start by acknowledging their current experience. Recognize and verbally let them know you understand what they may be feeling.
Come from a place of service, “I understand why you are feeling a bit stressed, and I can only imagine what this is currently impacting — is there anything I can do to help?”
In this stage of empathy, sharing a past experience that shows you’ve processed this feeling before stating what worked for you may serve them as well: “Last month my boss neglected me and all my work. I felt super stressed because I was not being recognized. However, once my colleague let me know she will make sure my boss sees my work, I felt a bit better. Plus, I spent a few days surrounding myself by supportive friends and colleagues who helped me realize my true worth. And you are worthy too.”
People who have struggled with trauma may be reluctant to accept your help. Be mindful of their decisions and remain supportive. The key to serving someone who has stress, anxiety, fear, or worry is to let them know you see, hear, and understand what they are going through.
Call to Action: accountability & responsibility
I am ending this story with a call to action to any reader.
Your ability, strength, and power to successfully empathize with people in general or with trauma is completely dependent on YOUR own level of self-processing. If you have experienced serious or extreme stress in your life (trauma), it is your responsibility to do the work.
Personally, my practice of self-processing, self-exploration, and coming to terms with my emotional past has exponentially increased my ability to empathize with others who’ve experienced trauma.
As human beings, we should try and be accountable for what’s happened to us even when it’s not our fault. We need to work on accepting ourselves and serving others through the use of empathy. Empathy is a full circle process.
The more empathy and compassion we have to go around the better.
Thank you for reading! :)
Trauma and Memory — Peter A. Levine, PhD
The Body Keeps The Score — Bessel Van Der Kolk, M.D.