What do you experience when you have been through trauma?

It is not yet fully understood, although a lot is claimed on the internet. So how it works for you is a matter of becoming aware and learning. To help you with that awareness, here are a number of patterns that are often seen:

1. Dissociation

You may experience dissociation:

When you go through severe trauma, your mind can flee, as it were, to a place where the trauma does not have to be consciously lived through. You disconnect your awareness from the powerless situation, so that the pain, the violence and the brute terror no longer get through to you. It is a kind of check-out, but from your conscious self.

If you have been traumatised repeatedly, you can later slip back into a state of disconnected awareness when certain triggers bring the trauma back. This often happens unconsciously, so without you having conscious control over it.

This is called dissociation, and it can be seen as a way of dealing with stress.

Dissociation as a survival mechanism

Dissociation is your survival mechanism in response to a stressful event. It can be an unpleasant sensation.

People describe dissociation as follows:

• A feeling of being dazed, as if the world is far away, unreal or not real;
• As if your own person feels strange and disconnected;
• As if you perceive your surroundings through a mist or a steamed-up window;
• Not being able to reach your own feelings;
• Having no feeling left at all.

This last one in particular is a very tormenting experience.

How long does dissociation last?

Dissociation can last a few minutes, but it can also go on for hours, or even weeks or months.

Dissociative fugue

If you dissociate often, you can experience ‘gaps’ in your memory, because things are not stored properly during dissociation. Sometimes you can also develop a ‘fugue’, for example actually travelling somewhere during the dissociation without being aware of it. You then ‘wake up’ in a place without knowing how you got there.

2. DID: multiplicity of your personality

Sometimes, through repeated check-outs and changes in your state of consciousness, trauma can lead to a picture of ‘multiplicity’ in how you experience your personality. You then have the feeling that there are several personalities. That can raise many questions, for yourself and for the people around you. DID stands for dissociative identity disorder.

In practical terms, the concept of multiplicity can help you to understand the consequences of chronic trauma better. It can also help your treatment. It is then used as a construct to find a balance between the different intense states of being that show themselves in you in turn, and that can ‘settle’ in the personality, as it were.

Two (or more) personality states

You can picture it as a condition in which you alternately take on two (or more) distinguishable personality states. Some of these personalities then regularly more or less take over your behaviour.

You can experience gaps in your memory that have nothing to do with forgetfulness. And your original personality sometimes knows little about your other personalities.

States of being that are linked to (surviving) trauma

So these are different ‘states of being’ of yours that are linked to (surviving) trauma. It can help a lot if you and your therapist name the different ‘parts’ and/or personalities together.

That way you can learn to accept these states of being and to deal with them better in daily life. A transpersonal or spiritual way of working can fit well with this.

3. Freezing up

You may experience freezing up

Early trauma can lead to later overactive freeze responses to stress in daily life. When you are faced with a terrible and dangerous opponent that you cannot possibly defeat and cannot safely escape from, this kind of freezing or paralysis can occur.

For example:

A freeze response is often observed in the animal kingdom and is one of the ways in which animals deal with the overwhelming stress of falling prey to another animal.

During ‘freezing’, your heart rate can go up or down, and you may hold your breath or restrict your breathing. This paralysis is just as adaptive as fighting the enemy or fleeing from it.

The freeze or self-paralysis is, like the better-known patterns of fight and flight, a survival mechanism of trauma that can keep repeating itself unconsciously later in life. The experience of ‘freezing’ or ‘numbing’ is described as feeling physically, mentally and emotionally paralysed by a state of alarm. The freeze means that you do not have to feel the enormity of what is happening to you. In that sense it is close to dissociation.

4. Fight-flight reactions

A well-known reaction to trauma is the so-called fight/flight response. This is the reaction of rapidly rising stress, scanning, tension, discharge and aggression, and everything else that is needed to escape and to survive the struggle.

Stress hormones

In the fight-flight reaction your body releases adrenaline and cortisol, the stress hormone. These hormones are released very quickly.

This can affect you in the following ways:

• Your heart beats faster to bring oxygen to your main muscles.
• Your breathing speeds up to deliver more oxygen to your blood.
• Your peripheral vision increases, so that you can take in your surroundings. Your pupils widen and let in more light, so that you see better.
• Your ears ‘prick up’ and your hearing becomes sharper.
• Your blood thickens, which increases the clotting factors. This prepares your body for injury.
• Your skin may produce more sweat or turn cold. You may look pale or get goosebumps.
• Hands and feet. As the blood flow to your main muscles increases, your hands and feet can become cold.
• Pain perception. Fight-flight temporarily reduces your perception of pain.
• Extreme vigilance and anticipation of threat arise, which can turn into paranoia and hearing voices.

Physiological reactions

Your specific physiological reactions in fight-flight depend on how you usually respond to stress. You can end up in a state of alternating between freeze and fight-flight, but this is very hard to sustain. Usually your body returns to its natural state after 20 to 30 minutes.

People with early trauma can end up in such a state of tension, discharge and aggression very quickly in daily life, in response to small things.

5. Fawn response

Appeasing to avoid conflict

The fawn response means that you try to appease a person (to please them) in order to avoid conflict.

The parent (or an important authority figure) as abuser

This reaction is common in childhood trauma where a parent or an important authority figure is the abuser. Children can then develop an appeasing response to try to avoid the abuse, which can be verbal, physical or sexual, by pleasing the other person.

Pleasing as a pattern

In other words, they try to soothe the abuser in advance by agreeing, by answering what they know the other person wants to hear, or by ignoring their own feelings and wishes and doing anything and everything to prevent the abuse. Over time this fawn response becomes a pattern.

People also use this pattern of behaviour in their adult relationships, both professional and personal.

6. Post-traumatic stress disorder (PTSD)

If you are troubled a lot by a combination of the experiences above, this may be PTSD.

PTSD is the situation in which the trauma keeps showing itself in the form of re-experiencing (memories, seeing images, hearing sounds, nightmares), a combination of freeze, fight, flight and fawn reactions that go together with strong negative thoughts and/or numbed feelings, and avoidance of things that directly or indirectly remind you of the trauma.

When is it called complex PTSD?

People speak of complex PTSD when there has been, for example, chronic severe sexual abuse. In such situations a simple EMDR treatment is often less suitable.

With complex PTSD, ‘exposure’ (having the person go back to the trauma in their experience) is also often not desirable or possible.

PTSD and psychosis-like experiences

PTSD often goes together with psychosis-like experiences (for example hearing voices, paranoia), and sometimes the distinction between PTSD and psychosis susceptibility cannot be made clearly.

That does not say much about what is going on with the person concerned. It mainly means that mental distress, certainly mental distress in the context of trauma, does not keep to the artificial categories of the DSM. All DSM diagnoses turn out to overlap constantly and to merge into each other over time.

Looking at these questions from the consequences of trauma

A better way to look at diagnostic questions like these is from the consequences of trauma itself. Trauma can dysregulate body and mind to such an extent that symptoms and pictures from literally the whole DSM can result. So nothing needs to be surprising.

Keep looking with wonder

It is best to look at each person with fresh wonder every time, without too many ideas at the back of your mind about how the world ought to work.

7. Other things you may experience with trauma

The phenomena described above often occur as part of a much broader range of things.

If you have been traumatised, especially when it concerns sexual trauma, you often also experience:

• An eating disorder
• Compulsions
• Depression
• Psychosis
• Personality problems
• Addiction
• A wish to die

It is important that you are then not treated for each thing separately (which unfortunately still happens), but that everything is looked at together and in connection. You cannot tackle everything separately in a ‘specialist’ way, precisely because it is all connected.

Expertise by experience matters

Expertise by experience is very important in this integrated view. Body-oriented work is important too, because everything is often connected with ‘disconnect’, estrangement or even aversion to your own body and your own feelings.

What is the impact of trauma?

Read on about the impact of trauma on body and mind and about the personal meaning of trauma.

Do you need help now?

PsychosisNet offers information. We do not offer a chat, a helpline or crisis support. If you or someone else is in immediate danger, call the emergency number in your country. If you are thinking about suicide, or you need to talk to someone now, see Need help now? for helplines by country.

Prof. dr. Jim van Os, Chair Division Neuroscience, Utrecht University Medical Centre. Jim works at the interface of ‘hard’ brain science, health services research, art and subjective experiences of people with ‘lived experience’ in mental healthcare. 

Jim has been appearing on the Thomson-Reuter Web of Science list of ‘most influential scientific minds of our time’ since 2014. In 2014 he published his book ‘Beyond DSM-5‘, and in 2016 the book ‘Good Mental Health Care’. In 2026 he published 'Wat psychisch lijden is'.

Want to read more?

Blogs by Jim van Os can be read here

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