Does trauma cause health issues or do health issues cause trauma?

Over the years I've spoken to many people who have shyly told me that they didn't think they had trauma, but do think that they've had major stress that may have impacted on their health. Others have told me definitively their childhood stress or trauma has absolutely nothing to do with their health – and I should add, sometimes it doesn't. I myself, when I got ill with bladder symptoms that seemingly had 'no cause' vehemently rejected any connection with trauma.

I've previously written about the definition of trauma, differentiating it from adversity and chronic stress. When making this distinction, I've also emphasised that biologically they both are on the same continuum with extreme trauma at the extreme end of the spectrum and adversity a little further down. What this spectrum doesn't take into account is time-span. Little drips of the same poison over time can culminate in similar effects to one big dose of poison all-in-one.

The research is pretty definitive on this one and shows a dose-dependent relationship. The more adversity or trauma you experienced (which may equate to more extreme, different types of adversity or trauma, or frequency or length of experience of trauma), the more likely you are to develop a chronic illness(1,2).

Items 3, 4, 7, 9 are experiences that many a person shrugs off 'that's just how it was' , minimising the impact because they haven't ever had it acknowledged as something significant. Even with the other items depicting physical abuse or threat to safety, it can be common for peoples' brains to have also found some way to minimise, which can be very protective, as well as prohibitive of healing.

One study found that childhood trauma increased the odds of developing chronic fatigue syndrome by 500% (6 fold increase) (3). Along with sexual abuse, emotional abuse and neglect were the types of trauma that significantly differentiated those with CFS from their study counterparts. Not being tended to when upset, being told you are embarrassing or making problems for the grown-ups, being ignored or cold-shouldered, are all examples of the sorts of experiences that constitute these risk factors. Again, these are things that are often dismissed as 'that's just how it was at home' or 'my parents had their own stuff' or 'it wasn't bad compared to…'

Again we've got more definitives from the research here. Research shows that one-off extreme instances of trauma like in the context of PTSD can make it more likely for you to develop health issues (9,10). Research also shows that experiencing ongoing, cumulating stress also makes the development of a chronic illness more likely (11,12).

Or “yes that did happen to me, but that was months ago and I was fine since, so this can't be related!”

In therapy with 100s if not 1000s of people now, I've heard trajectories of stress and health and how they cooccur and shape each other. Another reason that you might not readily identify with the idea that stress or trauma had a role to play in the onset of your illness, is because in contrast to getting ill, your life was not stressful at all! You were cruising through doing life without much concern and doing what you needed to do. The most notable trauma being when you started experiencing health issues. I hear you.

I previously defined trauma, as is used to conceptualise the diagnosis of post traumatic stress disorder (PTSD), as 'exposure to actual or threatened death, serious injury, or sexual violence'. When people have health issues, there is lots of exposure to actual or threatened serious injury (or harm, which is used interchangeably in this definition of trauma), just by the experience of symptoms. Pain is an experience of harm. Add to that the appraisals we might have if that pain is unexplained like 'something really bad is happening in my body' or 'this could be a sign of a serious illness that will get worse', all brain processes are those of high-threat and alarm. In the context of other illnesses, where the aetiology is known, the threat may be just as great or greater. For example, in endometriosis where there may be sorely inflamed lesions, or in inflammatory bowel disease where there may be tissue degradation, these bodily changes would classify as injury or harm. Just because there is no external force or perpetrator, doesn't make it less traumatic.

Childhood trauma dramatically increases your risk of chronic illness: The research is definitive - adverse childhood experiences create a dose-dependent relationship with disease risk, with ACE scores of 4+ significantly increasing your likelihood of developing chronic conditions