The Anatomy of Harm: How Abuse Impacts Your Brain, Body, and Psyche

Introduction

Psychological abuse can have profound and lasting effects on individuals, particularly when the abuse is perpetrated by those they trust, such as friends, close colleagues, or family members. Ongoing psychological/emotional abuse, particularly if experienced early in life, is a significant predictor of relational trauma and post-traumatic stress.

Defining Psychological Abuse

Psychological abuse, also known as emotional abuse, is a pattern of behaviors used to control, manipulate, intimidate, or undermine an individual’s sense of self-worth and emotional well-being. These behaviors commonly include verbal assaults, threats, isolation, and coercive control (O’Leary, 1999; Straus, 1979; Walker, 1979). This form of abuse targets the victim’s psychological integrity and can cause lasting emotional harm even without physical violence. In the United States, approximately 1 in 7 children experience psychological or emotional abuse by caregivers or family members annually (Sedlak et al., 2010; U.S. Department of Health and Human Services, Administration for Children and Families, 2023). Nearly half of American women (48.4%) and men (48.8%) report directly experiencing psychological aggression by an intimate partner in their lifetime, reflecting the widespread nature of psychological abuse across family and intimate relationships (Smith et al., 2017). Approximately 1 in 15 children witnesses intimate partner violence (U.S. Department of Health and Human Services, Administration for Children and Families, 2023). Witnessing such abuse places children at significant risk for emotional, behavioral, and developmental problems, even if they are not direct victims of the abuse.

Extending this concept to workplace settings, bullying has been identified as a form of psychological abuse with profound life, health, and cognitive consequences (Einarsen et al., 2003; Leymann, 1990). Workplace bullying is defined as unwanted acts of aggression, manipulation, or isolation that persist for six months or more in a setting where a power imbalance makes it difficult to defend oneself (Einarsen et al., 2003). Nearly half of US workers report experiencing or witnessing bullying (Namie, 2024). Targets of workplace bullying frequently report a range of emotional reactions, including fear, anxiety, helplessness, depression, irritability, social isolation, and shock (Grynderup et al., 2017; Nielsen et al., 2015; Verkuil et al., 2015). These responses correspond to the PTSD symptoms defined in the DSM-IV-TR: re-experiencing, avoidance, and heightened threat perception (American Psychiatric Association, 2000). Consequently, researchers have found that victims of workplace bullying frequently display symptoms associated with post-traumatic stress disorder (PTSD) (Mikkelsen & Einarsen, 2002; Leymann & Gustafsson, 1996).

Defining Trauma

Leading trauma experts provide a nuanced definition of what trauma is. Judith Herman (1992) describes trauma as an overwhelming experience that exceeds an individual's psychological capacity to cope, fundamentally disrupting normal adaptation. Bessel van der Kolk (2014) views trauma as a bodily experience that becomes "stored" in somatic memory, affecting neurological functioning beyond immediate psychological responses. Peter Levine (2010) defines trauma as a disruption of an individual’s natural self-regulatory systems, creating a persistent state of physiological dysregulation. He noted, “rather than being a disease in the classical sense, trauma is instead a profound experience of ‘dis-ease’ or ‘dis-order’” (p. 34). Building on this, Donald Kalsched (1996) describes the distinguishing feature of trauma as “an unnamable dread associated with the threatened dissolution of a coherent self” (p. 1), highlighting trauma’s power to fracture one’s very sense of identity. Bonnie Badenoch (2017) emphasizes the relational aspect of trauma, stating that it often arises from feelings of isolation and abandonment during distressing events. She highlights the significance of interpersonal relationships in both the experience of trauma and the healing process. Individuals are particularly impacted by the abuse of trusted others. Freyd (2008) describes the unique pain caused when those depended upon for protection violate trust as “betrayal trauma.” Laura Kerr (2010) further observes that the English language itself "lacks a word to describe the emotional suffering caused by human cruelty"—a suffering that is, at its core, trauma. These perspectives speak to the profound existential and linguistic challenges inherent in defining and understanding the full impact of trauma. Importantly, not every overwhelming or adverse experience results in trauma; individual resilience, support, and context play a critical role in how events are integrated or transformed.

Neurological Impact

Trauma, in particular childhood trauma, fundamentally alters brain architecture, impacting critical regions such as the prefrontal cortex, amygdala, and hippocampus, but also brain chemistry. These neurological changes manifest through hyperactive salience networks, increasing threat sensitivity, compromised executive functioning, impaired memory processing, and reduced cognitive flexibility. Such a change leads to a different way of being in the world. Individuals who experience trauma often face significant cognitive challenges, including difficulty concentrating, memory fragmentation, reduced problem-solving capabilities, and heightened emotional reactivity.

A critical yet often overlooked aspect of trauma is stress-induced anesthesia, a dissociative response that numbs emotional and physical pain. This neurobiological defense mechanism helps individuals endure overwhelming stress by dampening sensory and emotional processing. Chemically, it involves alterations in neurotransmitters such as GABA, glutamate, and endogenous opioids, as well as dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis (Boulet et al., 2022). Neuroimaging reveals reduced activity and connectivity in the amygdala and prefrontal cortex during this state, enabling protective emotional detachment but impairing regulation and integration of traumatic experiences (Lanius et al., 2015; Schauer & Elbert, 2010). While beneficial for short-term survival in abusive environments, this response can lead to prolonged disengagement, fragmented memory, and difficulty processing trauma, complicating recovery. These effects can trap survivors in cycles of confusion and vulnerability, often making it extremely difficult for them to recognize the need or find the capacity to leave abusive relationships or toxic workplaces. This neurobiological "numbing" reinforces their entrapment, increasing the risk of chronic stress-related disorders such as burnout and depression, and impairs healing and reintegration. Recognizing stress-induced anesthesia deepens our understanding of the profound impact of workplace abuse and highlights the urgent need for trauma-informed, brain-body integrated healing approaches that address both psychological and physiological dimensions of trauma (Boulet et al., 2022; Lanius et al., 2015; Schauer & Elbert, 2010).

Understanding these neurological impacts requires a recognition of how relationships and therapeutic environments influence brain functioning and healing. In The Developing Mind, Daniel Siegel (2020) highlights how relationships shape the brain's development and functioning. He posits that the integration of neural networks is crucial for emotional regulation and cognitive processing. Disruptions in these processes due to trauma can lead to incoherent narratives and difficulties in self-regulation, impacting overall mental health (Siegel, 2020). Bonnie Badenoch (2008), in Being a Brain-Wise Therapist, builds on this by integrating interpersonal neurobiology into therapy. She emphasizes that effective treatment must consider trauma’s neurobiological underpinnings to create healing spaces where survivors can rebuild safety and connection (Badenoch, 2008).

Impact on the Body

Bessel van der Kolk (2014) emphasizes that trauma is fundamentally an embodied experience, deeply embedded in the somatic memory of the organism. This trauma alters brain-body communication, disrupting the body's innate ability to regulate arousal and return to calm. Trauma survivors often live in sustained states of hypervigilance or immobilization, which manifest as a constellation of somatic symptoms including muscle tension, gastrointestinal distress, disrupted sleep, and heightened pain sensitivity.

These somatic manifestations are underpinned by fundamental biological transformations triggered by trauma exposure. Notably, critical alterations occur in the hypothalamic-pituitary-adrenal (HPA) axis, the body’s central stress regulation system, leading to chronic activation of stress responses that have profound effects on overall health (NCBI Bookshelf, 2001). This dysregulation can manifest as either hyperactivation or hypoactivity of the HPA axis, leading to a wide range of health issues, including cardiovascular problems, immune suppression, neurological impairments, and musculoskeletal disorders (Schwabe et al., 2012; Van der Kolk, 2014).

Such chronic HPA axis dysfunction also underlies many psychosomatic symptoms—physical complaints that lack an identifiable medical cause but are closely tied to trauma’s neurobiological effects. These symptoms frequently include sleep disturbances, persistent muscle tension, and gastrointestinal problems, illustrating the critical mind-body interplay in trauma’s impact (Levine, 1997; NCBI, 2001).

Moreover, early trauma, especially during sensitive developmental periods such as infancy, can produce long-term alterations in the circadian regulation of stress hormones, increasing vulnerability to mental and physical health problems across the lifespan (Hoeboer, 2021). The Adverse Childhood Experiences (ACEs) study established a clear link between childhood trauma and various chronic health conditions later in life. Individuals who experienced multiple types of childhood adversity were found to have increased risks for conditions like cancer, diabetes, and respiratory diseases (Felitti et al., 1998).

Understanding trauma’s impact on the body as a dynamic brain-body dysregulation process highlights the central role of trauma-informed somatic therapies. Interventions like Somatic Experiencing® leverage body awareness and nervous system regulation to restore autonomic balance and facilitate healing from the chronic physiological wear trauma inflicts (Levine, 1997; van der Kolk, 2014).

Impact on the Psyche

Trauma profoundly disrupts the psyche, often fracturing the cohesive sense of self that develops through early relational and developmental experiences. Foundational psychoanalytic theorists like Sigmund Freud (1916/1917) laid the groundwork for understanding how traumatic experiences generate psychic conflict, repression, and ego fragmentation. Freud conceptualized trauma as an overwhelming event that the psyche is ill-equipped to process, resulting in symptoms such as anxiety, dissociation, and neurosis. Donald Kalsched (2014) expanded the understanding by exploring how trauma fragments the self through the creation of dissociative defenses. While protective, these defenses complicate healing by fostering isolation, shame, and disconnection from one’s essential self, emphasizing the emotional landscape of trauma survivors and the disruption of internal cohesion.

Carl Gustav Jung (1969), initially a close collaborator and protégé of Sigmund Freud—often described as a student or "heir" to Freud's psychoanalytic work—expanded the understanding of trauma’s impact by emphasizing the role of the unconscious and archetypal dimensions of the psyche. Jung (1969) viewed trauma as a disturbance in the delicate balance of conscious and unconscious elements, triggering shadow aspects of the self that complicate integration and wholeness. His work on complexes highlighted how trauma engenders fragmented parts of the personality that act autonomously, influencing behavior and emotional responses unconsciously.

Building on working with the unconscious, Marie-Louise von Franz (1996), a prominent Jungian analyst, emphasized its importance not only for restoring psychic integrity after trauma but also for using symbolic understanding to facilitate individuation. This process of integrating unconscious contents into conscious awareness is often stalled in individuals with relational trauma, making their insights crucial for deep healing (Jung, 1969; von Franz, 1996).

Marion Woodman (1993), renowned for her feminist Jungian perspective, underscored how trauma uniquely impacts the feminine psyche by inducing disconnection from the body, creativity, and emotional authenticity. Woodman stressed the importance of reclaiming embodiment and emotional expression as critical steps for trauma recovery, particularly in women subjected to relational and institutional abuses.

Empirical research supports these clinical insights, showing individuals exposed to emotional abuse are three times more likely to develop depressive disorders than those without such histories (Finkelhor et al., 2012). These findings underscore trauma’s deep psychic wounds, which impair affect regulation, identity, and relational capacity.

Together, these psychoanalytic and Jungian perspectives alongside contemporary trauma theory illustrate trauma’s multifaceted disruption of the psyche—cognitively, emotionally, unconsciously, and symbolically—necessitating integrative approaches that honor the complexity of fragmentation and the critical path toward restoration and wholeness.

Impact on Current/Future Interpersonal Relationships

Trauma profoundly disrupts an individual's capacity to form and maintain healthy relationships. Judith Herman (1992), a pioneer in trauma studies, highlights how traumatic experiences can lead to the development of insecure attachment styles, challenges in establishing healthy emotional boundaries, potential social withdrawal, and intense emotional regulation difficulties. Research indicates that trauma can lead to maladaptive relational patterns where survivors may struggle with communication, leading to misunderstandings and conflicts in their interpersonal relationships (Herman, 1992; Zaleski et al., 2016). This relational dysfunction can perpetuate feelings of isolation and exacerbate mental health issues.

Building on this perspective, attachment theory, originally developed by John Bowlby, explains how early caregiver relationships shape internal working models of self and others, guiding future relational expectations and behaviors. Secure attachment, fostered by consistent and supportive caregiving, supports trust and emotional regulation. In contrast, insecure attachment styles—anxious, avoidant, and disorganized—arise from inconsistent or traumatic caregiving, leading to difficulties in intimacy, trust, and emotional regulation (Ainsworth et al., 1978; Main & Solomon, 1990). Diane Poole Heller (2010) expands on this by focusing on the neurobiological imprint of attachment trauma. She describes how early relational trauma disrupts nervous system regulation, causing survivors to experience hypervigilance to social threats or emotional numbing that impede their ability to form secure relationships.

Additionally, Freud’s concept of repetition compulsion illustrates why individuals with trauma histories may unconsciously seek out partners resembling past abusers in attempts to resolve unresolved conflicts. Childhood trauma survivors often find themselves attracted to relationships that echo earlier abusive dynamics, perpetuating cycles of emotional pain and disappointment (Herman, 1996; van der Kolk, 1989; PMC, 2011).

Individuals who experience trauma may also unconsciously reenact past traumas. Freud’s (1920) concept of repetition compulsion helps explain why individuals with trauma histories may unconsciously seek out partners who resemble their past abusers in an attempt to resolve unresolved conflicts. Childhood trauma survivors often find themselves attracted to relationships that echo earlier abusive dynamics, perpetuating cycles of emotional pain and disappointment (Herman, 1996; van der Kolk, 1989; PMC, 2011). This unconscious pattern involves recreating familiar but harmful relational dynamics, driven by a deep psychological need to master or make sense of past trauma. However, because these patterns are rooted in unresolved wounds, they often result in repeated emotional suffering and relational dysfunction.

Impact on Coping Mechanisms

Trauma significantly influences how individuals develop and employ coping mechanisms, which may be adaptive or maladaptive depending on the context and underlying unresolved distress. Gabor Maté (2010) highlights the profound link between trauma and addiction, emphasizing that unresolved trauma can drive people toward unhealthy coping strategies as attempts to manage overwhelming emotions and somatic distress. These coping behaviors include substance abuse (alcohol, drugs), overworking, and compulsive activities such as gambling, overeating, and other behavioral addictions.

Such maladaptive coping arises partly because trauma disrupts natural self-regulatory systems, leaving individuals vulnerable to strategies that provide short-term relief but have long-term harmful consequences (Levine, 1997). In response to chronic psychological and physiological dysregulation, trauma survivors often seek ways to numb emotional pain or regain a sense of control, which can perpetuate cycles of addiction and self-harm (Maté, 2010; NCBI, 2001).

Coping mechanisms also extend beyond overt addictions to subtler forms of avoidance and dissociation, including emotional suppression, social withdrawal, and dissociative zoning out. These responses, although protective in the immediate aftermath of trauma, can impede emotional processing, relational engagement, and overall recovery (Kalsched, 2014).

Effective trauma-informed care recognizes the diversity of coping mechanisms and aims to support survivors in developing healthier alternatives that foster resilience and integration. Healing approaches such as Somatic Experiencing® (Levine, 1997), trauma-sensitive depth psychology, and psychotherapy help cultivate awareness, emotional regulation, and reconnection with the body, offering pathways out of harmful coping patterns.

Understanding trauma's impact on coping underscores the critical need for compassionate, individualized treatment that addresses both the psychological and somatic dimensions of trauma responses. By validating survivors' coping struggles and facilitating neurobiological and emotional healing, such care enables the restoration of self-regulation and sustainable well-being.

Healing and Recovery After Abuse

The journey toward healing from complex trauma is intricate and multifaceted. Expecting a person who has endured repeated psychological abuse to manage their emotional and physiological responses as if they are unaffected by their past experiences is unrealistic and unjust.

Peter Levine's Somatic Experiencing® approach focuses on healing trauma through body awareness, allowing survivors to process traumatic memories indirectly by tuning into bodily sensations rather than directly confronting distressing thoughts (Levine, 1997; Payne et al., 2015). Survivors often experience visceral reactions that trigger protective mechanisms as their bodies instinctively remember the potential for harm. SE® recognizes these protective mechanisms and aims to help individuals regain a sense of safety and control.

Effective trauma treatment requires a nuanced approach that integrates various therapeutic modalities tailored to each survivor's unique experiences (Herman, 1992). Comprehensive interventions should consider emotional landscapes, individual triggers, and historical contexts to foster genuine healing. By creating supportive environments that honor individual experiences, we empower survivors to reclaim their lives, rebuild their identities, and navigate the complex landscape of trauma recovery. Simplistic solutions fail to encompass the complexities of trauma recovery and can inadvertently invalidate a survivor's lived experiences, reinforcing feelings of isolation (Herman, 1992; Zaleski et al., 2016).

By fostering an understanding of these intricate dynamics, we can create an environment conducive to genuine healing and resilience, enabling survivors to reclaim their lives and rebuild their identities in ways that honor their experiences and promote their well-being.

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