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Dissertation Diary Part 2: Sex Trafficking’s Impact on the Body

Part 2 of the Dissertation Diary blog post series  (For more context- please refer to Dissertation Diary Part 1)

<Please note that this “Dissertation Diary” 5 part blog post series is formatted very differently than the rest of my articles– much longer and more academic than the others…For other articles, please refer the right navigation panel of the site.>


The Body Keeps Score

Many people fail to recognize that when you experience trauma, everything from a car accident to a rape or a sex trafficking experience, you can’t just treat the extremes- on one hand, viewing the person through a purely medical lens (treating the pain symptoms of the body) and on the other hand, treating the person purely through mental health interventions to treat things like anxiety and PTSD…

No, you have to recognize that it’s like a venn diagram– one circle is body, one circle is mind and there is intersection. The body will manifest what’s wrong with the mind and the mind will manifest what’s wrong with the body. It’s a two-way street, an interrelated system…

I agree with Babette Rothschild’s statement (2000) “The body remembers (Wainrib, 2006)” and with Bessel Van der Kolk, ”The body keeps score(2004)” (Wainrib, 2006). 

Long after the trauma incident (finite in time), the body locks in that trauma and can perpetuate that trauma.

Trauma specialists, Levine and Brooke, claimed that trauma not only manifests mentally but also in the body (Levine, 2010) and the consequences for survivors can be particularly long lasting and devastating because of the intimate nature of the violence of sexual abuse and violation of the body (Brooke, 2007).

Author, Tian Dayton, has been researching trauma and addiction for the past decade, and pointed out that in sexual trauma, the body is the birthplace of pain and abuse (Dayton, 2010) so it would make sense that the body would manifest that trauma in negative somatic ways.

In this section of Dissertation Diary Part 2, I will be examining research from the fields of Interpersonal Neurobiology, Somatic Experiencing, and Neuroscience as they offer a wealth of knowledge about the constellation of physical symptoms resulting from how the body processes trauma.


Survival Mode

The “Fight and flight” survival mode is a well- known and generally accepted phase of the trauma experience but let’s take a closer look at what happens during that phase and the aftermath.

When examining fight and flight, you have to examine the formation of trauma symptoms post abuse and post attack too. Researchers such as Dayton and Williams described that the body and brain provisionally react to a threat by invoking primitive states of fight, flight, or freeze (Dayton, 2010)(Williams, 2006). Freezing occurs as the most primal response when an individual is unable to fight or flee from the threat of an attack (Dayton, 2010).

Renowned somatic trauma specialist, Dr. Peter Levine pointed out that even after the direct threat, the body and brain remains in primordial stages of fight, flight and freeze as a protective mechanism (Levine, 1997).

Although the event may have passed in time and disappeared from conscious memory, the body does not forget. Levine explained that before the body is able to resume a state of relaxation from the alertness, there seems to be a physiological need to complete and conclude any unfinished sensory-motor impulses that were started. The survivor’s defense mechanisms of a survivor can cause the individual’s system to become ‘stuck’ in a persistent state of alertness.

Dayton asserted that because of this continual impact of the traumatic and abusive circumstances, the survivor may experience negative symptoms such as an increased heart rate, respiration, anxiety, and challenges sleeping (Dayton, 2010). She emphasized that if the person could release the energy instantaneously following the attack, by fleeing or defending themselves, the threat cycle in the body response would be settled and the trauma would not develop (Dayton, 2010). Levine (1997) concurs with Dayton’s assertion that “in humans, trauma occurs as a result of the initiation of an instinctual cycle that is not allowed to finish” (Dayton, 2010).

Additionally, Bremner claimed that this fight or flight response from the trauma of  sexual abuse will also awaken cortisol responses with a flood of hormones and neurochemicals. The result? Far reaching impact on the mind, brain, and body, and increased susceptibility to a number of physical ailments including cardiovascular disease and diabetes (Bremner, 2002).

In Van der Kolk’s view, trauma is in the nervous system, not in the event (Van der Kolk, 2007). The trauma goes beyond the incident or experience. Both Van der Kolk and Bremner agree that during the intense, severe, prolonged stress response that the same parts of the body that are most sensitive to the wear-and-tear effects of stress over time are those areas that are activated (Bremner, 2002) (Van der Kolk, 2007).

Take the girl out of the trauma but…can you take the trauma out of the girl?

Like Levine, Dayton believes that hypervigilance, an increased sense of arousal and responsiveness to stimuli, may develop in an individual as an attempt to protect them from future threats or attacks (Levine, 1997) (Dayton, 2010). Across the board, the experts in the trauma field, such as Levine, Dayton, and Scaer, all uphold that the energy that is trapped in the body by freezing produces a variety of physiological effects. This energy can damage the nervous system, cause adverse body and brain responses that impair physical, emotional, and mental functioning, and instigate levels of anxiety, disassociation, internalized rage, and sadness (Levine, 1997) (Levine & Kline, 2007)(Dayton, 2010) (Scaer, 2007).

The symptoms of hypervigilience seem to progress and change over time. In their work examining hypervigilience, Levine and Frederick found that early presenting symptoms may include intrusive imagery/flashbacks, acute sensitivity to light and sound, hyperactivity, exaggerated emotional responses, hallucinations and night terrors, unexpected mood swings, decreased ability for stress management and challenges sleeping (Levine & Frederick, 1997).

They identified that in the next phase of hypervigilience after the attack or abuse, the symptoms tend to develop into panic attacks, anxiety, phobias, mental blankness, overstated frightened response, severe sensitivity to light and sound, hyperactivity, hyperbolic emotional responses, nightmares and night terrors, avoidance behavior,  recurrent crying, sudden mood swings, overstated or reduced sexual activity, amnesia, forgetfulness, incapacity to love, nurture, bond, or a dread of dying. Extreme shyness, muted, reduced emotional response symptoms seem to develop last (Levine & Frederick, 1997).

Free but not well

As illustrated in the case of “Anna” in my Dissertation Diary Part 1, many victims may get rescued but are free, but not well.

Beyond the inherent physical dangers of sex trafficking, such as sexual disease and hygiene problems, Dr. Robert Scaer, a leader in the field of trauma and healing, point to many somatic issues that come from the traumatic stress itself. Traumatic stress seems to be epidemiologically linked to depression and behavioral changes and affects physical health. This can also cause a host of other problems such as heart disease, infection, smooth muscle spasms, ulceration in the gastrointestinal system, esophageal cardio spasms, gastro esophageal reflux disease (GERD), peptic ulcer disease, ulcerative colitis, regional ileitis, irritable bowel syndrome, and the classic migraine (Scaer, 2007).

Re-inhabiting the Body

I could go on and on about the damaging impact of sexual trauma and sex trafficking on sexual and physical health…

Sexually, there is risk of infection and internal tears, untreated sexually transmitted infections, pelvic inflammatory disease, infertility, risk of meningoencephalitis in the infant born of the infected mother risk of HIV infection, hepatitis (Hanley, 2004), complications related to forced abortions (Jones, Engstrom, Hilliard, & Diaz, 2007)….

Physically, there is high risk of malnutrition, untreated wounds, skin infections (Hanley, 2004), other blood-borne infections, violence, accidents, solvents through drug use that can produce liver, kidney, brain damage (Hanley, 2004), forced substance abuse, physical abuse, and tuberculosis (Jones, Engstrom, Hilliard, & Diaz, 2007), broken bones, lice, unhealthy weight loss, headaches, vision disturbances (Jones, Engstrom, Hilliard, & Diaz, 2007), gastrointestinal problems, (Jones, Engstrom, Hilliard, & Diaz, 2007) (Scaer, 2007), and pelvic, abdominal, low back, myofascial pain (Scaer, 2007).

But beyond these horrific outcomes, one of the areas that absolutely will require therapy (not medical attention) to bring resolve is the overwhelming sense of disconnection between the victim and their own body as a result of sexual abuse. Dayton and Scaer both concur that sexual assault and abuse often foster a sense of detachment in an unconscious internalization of the abusive experience (Dayton, 2010) (Scaer, 2007). In his research, Scaer even found that many times, memories of the trauma can trigger an arousal in certain body parts that can be selectively dissociated (Scaer, 2007). Additionally, Brooke note that this same feeling of disconnection may also extend to feelings of distrust, confusion, rejection, pleasure, helplessness, fear, shame, dislike, self-hatred, and hostility (Brooke, 2007). The progression of body/brain disconnection, where the victim disassociates from their body and body experience, causes these incidents and experiences of sexual abuse to grow into more advanced conditions of sexual trauma such as Post Traumatic Stress Disorder (PTSD).

Before there were words

In his book Integrating body self and psychological self, Dr. David Krueger shared his thoughts about the foundations of self. He asserted that before there are words or a language for a developing child, the earliest imprints from a mother on a child are through the bodily sensations and feelings. The original environment where the “foundational sense of self” was formed, was in the body fluids, sensations, sensory matching, and secure touch (Krueger, 2002).

I find myself agreeing with Krueger–When you relate that to this tendency to be detached from the body to the fact that many sex trafficking victims are very young/start young, there is a devastating result– the derailment of these normal early body experiences can cause missed development experiences of assimilating basic physical and experiential building blocks- which can further amplify an individual’s inability to articulate their own body and sensory consciousness. Their body seems to get locked “within an effective orbit of shame (Krueger, 2002).”

I will cover this more in Part 4 of my Dissertation Diary blog series — when the body is the original point of violation and abuse, it will require the body to be integrated into the therapy process to aim for holistic healing. The mind and body truly are interrelated. This serves as a foundation for a movement based therapy that goes behind the traditional ‘talk therapy.’

Medical attention can only do so much. Talk/psychotherapy can only do so much. To target the nuances of more complex negative outcomes like the dissociation with one’s body/sense of self or the two way connection of mind impacting body, body impacting mind…more is needed.

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