Updated: Nov 27, 2021
Trauma and Dystonia
Can trauma cause dystonia or other neurological disorders? Can our overall personal healing and growth contribute to dystonia recovery?
The Greek word “trauma” simply means “wound”: just like there are wounds of the body, there are wounds of the soul, or “psyche” in Greek. When we are injured, our bodies and minds do our best to help us survive: we heal what can be healed, and sometimes we are left with scars that mark us forever.
In such cases, we are forced to learn and adapt, and we do so through neuroplasticity - forming new connections and new patterns of thought, emotion, behaviour, movement and new ways of using our bodies. For example, a physical injury in our eyes may rob us of our sight but increase our ability to use our hearing to orient ourselves in the world; a traumatic childhood experience with a dog may cause us to be fearful of animals, and so on.
Paraphrasing the words of physician and trauma pioneer Gabor Mate, the most important thing about trauma isn’t the traumatic event itself, but what happens within us as a result of that event. In other words, what really shapes our lives is the survival response we develop and learn.
Some of these survival responses are adaptive - that is, they actually help us survive and thrive in our environment. Other responses are maladaptive, and may offer some sort of initial comfort, for instance, but end up harming us over the long term. This process of maladaptive neuroplasticity (i.e. a learned survival response that is harmful over the long term) is at the heart of many neurological, behavioral and psychological disorders - including dystonia.
Survival responses to trauma live in the body: patterns of thought, behavior and emotion are stored in and mapped on our nervous systems. Consider the example of a child who grows up in a violent home and learns to slouch in a shut-down position in order to “fly under the radar” and find safety; or the child who isn’t allowed to show emotions and ends up “freezing” his facial expressions.
In dystonia, these mechanisms take place in patterns of great complexity, where traumatic events in the psyche are sometimes layered on top of physical injuries, and in which the nervous system often dysregulates asymmetrically, resulting in a hypotonic (underused) set of muscles and a hypertonic (overused) one.
To summarize: dystonia is a form of maladaptive neuroplasticity in which the body is organized around a harmful input; trauma can constitute such an input.
If this is the case, how can we unlearn this maladaptive, dystonic response and learn a new, functional way of inhabiting our nervous system?
The journey towards healing is a complex one, and it varies from person to person. At a minimum, however, it includes the following elements:
Resourcing. When our nervous system is dysregulated, we need to make our way back to a sufficient degree of regulation before we are able to create change. Polyvagal theory provides a helpful general framework to think about this process: we seek to move from a pattern of excessive sympathetic activation (fight-or-flight) or shutdown (freeze) to one in which our sympathetic and parasympathetic (rest-and-digest) systems can oscillate in harmonious activation, allowing us to feel connected and safe in our environment. There are specific physical practices that can be used to invite this kind of regulation in the body; in general, they involve exposing ourselves to places, people, thoughts, sounds etc. that help us immediately and directly experience a sense of safety. Think of your favorite place as a child - somewhere like Grandma’s home, for example - and try to connect to that feeling of effortless belonging and comfort: that’s the state from which we can learn about ourselves, create change and heal.
Clear seeing. “Insight” or “clear seeing” are the most common translations of the Pali world Vipassana, known in the West as one of the main traditions of Buddhist meditation practice. In the path of dystonia healing, we are called to observe with clarity the patterns in our bodies and minds: the map of hyper- and hypo-tonic pathways, our emotions, thoughts, core beliefs, behaviours etc. For us to be able to see these survival adaptations clearly and walk the path of healing, we must cultivate equanimity: we must be able to be with our challenges and learn from them curiously, rather than immediately reacting by rejecting what is and rushing towards a different outcome.
Self-compassion. We cannot hate ourselves into changing and healing. The responses our brains have developed in order to survive are a direct consequence of missing inputs; we are called to observe ourselves lovingly and provide these missing inputs, like a parent observing a baby to understand their needs and then tending to them with unending compassion. Some of these missing inputs might be very physical, as in the case of a malocclusion that causes the brain to ‘forget’ a part of the face; others may be more subtle, yet very powerful - like giving ourselves permission to express our emotions if we were taught to repress them.
Creating a new reality. The freedom to create and practice new patterns in our nervous systems begins in this space of safety, awareness and compassion. Once we have provided ourselves with a missing input, we can begin to integrate it into the way we inhabit our body, the way we move, behave, interact and so forth. For example, someone who suffers from malocclusion can stimulate the hypotonic branch of her fifth cranial nerve and begin to use her jaw in a more balanced way, and ultimately get help from a skilled dentist to provide the missing input through careful restorations. As another example, someone who has developed a dystonic pattern in his tongue because he rarely feels safe when speaking, can gradually train himself to provide his brain with the messages of safety that allow to rewire the way he uses his tongue in social situations.
Dystonia that is tied to trauma seems to be often tied to adaptations and dysregulation that happen over time, rather than one-off traumatic events. An example of this could be traumatizing family dynamics during childhood and adolescence that contribute to dystonic patterns. Imagine, for instance, someone who learns to “fly under the radar” to avoid the wrath of a rageful parent and adopts a slouched defensive posture; this person may find it hard to properly use the muscles in his head and neck. When this maladaptive response is combined, for example, with a slight anatomical asymmetry in the cranium, an asymmetry can develop in the amount of electricity that flows through each side of the eleventh cranial nerve, resulting in visible cervical dystonia. For such an individual, dystonia recovery is going to entail unlearning the adaptive responses to trauma in addition to balancing the muscle tone in the neck.
The English word “healing” is related to the word “wholeness”. The path of dystonia healing truly exemplifies this: we are called to learn from our health challenges as we do from a teacher, understand ourselves through brave and compassionate inquiry, and create change in every aspect of our lives; it is, truly, a journey towards wholeness. Will you take the first step?