Respiratory/Circulatory Model

Trauma of all types can compromise both respiration and circulation of vital nutrients.  Direct physical trauma has the obvious effect of physically damaging structures such as nerves, arteries, lungs, and heart as well as more indirectly distorting nerves, arteries and shearing cells via fascial torsions and somatic visceral reflexes (damage to the soma [muscles, connective tissue] causing pain to the cutaneous nerves that originate at the same spinal cord level as certain organs such as the heart and lungs).  Respiratory compromise can cause an increase or decrease in heart rate and breathing rate, circulation dysfunction can cause gangrene, impaired blood flow, vulnerability to infection, hypoxia of tissues, etc.

In dealing with psychological trauma, there is suffering from chronic stress and PTSD from exposure to abusive or violent situations.  This chronic level of hypervigilance results in increased levels of hypersympathetic chemicals in one’s body (largely cortisol, epinephrine, and norepinephrine from the adrenal glands).  This is because the sympathetic (fight/flight/freeze) portion of their autonomic nervous system is in overdrive because this is serve to protect them from obvious dangers in the past.  Additionally, there parasympathetic (rest/digest) portion of their autonomic nervous system is hypoactive for the same reason.  Though these adaptations from the autonomic nervous system (not under direct control from the patient) are adaptive and have allowed the patient to appropriately escape or avoid dangerous situations that they have been exposed to, when this chronic stress continues over months to years, there are obvious deleterious effects on their body.  The increased cortisol that circulates in these patients over these long periods of time results in a hyper inflammatory state which may predispose them to inflammatory diseases (arthritis, asthma, allergies, recurrent infections). 

Thus, when dealing with the patient who has undergone trauma, it is important to keep in mind what the “root cause” of their complaint or diagnosis may actually be.  Too often, practitioners may consider the diagnosis of something such as arthritis as the root cause, when in fact it may be underlying unhealed traumatic events that is predisposing this patient to the given disease.  In addressing the primary event (AKA the “key lesion” in Osteopathic terms), a therapist or body worker may over time decrease maladaptive circulation issues.  Over time, chronically constricted vessels might dilate, and chronic circulation of pro-inflammatory chemicals and hormones may decrease.

When a traumatized person is subject to circulatory and respiratory compromise, it is easy to see how they may be predisposed to self medicate.  If you are in a constant state of rapid breathing, hypertonic vasculature, and impaired immunity; it is not unreasonable to trend towards the intake of substances that help ease these physical symptoms (such as alcohol and opioids) in addition to the chronic anxiety/panic that comes with it.  Thus, even from the respiratory/circulatory model perspective, we can see what addiction and trauma specialist Gabor Mate was alluding to when he said ““It is impossible to understand addiction without asking what relief the addict finds, or hopes to find, in the drug or the addictive behavior.”

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