People inflict the most complicated forms of trauma
Victims of a terrifying event perpetrated by another person are more likely to suffer from chronic pain than those who suffer a car accident, fire, or natural disaster, where no perpetrator was involved.
Some victims of violent events, such as rape, threats, or natural disasters, go on to develop mental health issues triggered by the event, known as post-traumatic stress disorder (PTSD).
A new PhD thesis reveals that patients with PTSD are more than twice as likely to live with chronic pain as other patients.
But the types of pain can vary dramatically according to the type of event.
“People who have survived car accidents and natural disasters, for example, have less pain than individuals who are victims of sexual assault or other violence perpetrated by another person,” says Johan Siqveland, PhD candidate at the University of Oslo and Akershus University Hospital, Norway.
Faster recovery when no perpetrators involved
Siqveland studied 70 patients who came to the pain clinic at Aker University Hospital in Norway. The patients were between 24 and 66 years old, and two thirds of them were women.
All of them had experienced a traumatic event in their life and everyone had suffered from pain for more than six months.
“Some had pain in one specific place in their body, most often in their back. Others had pain all over their body,” said Siqveland.
Siqveland found that people who had been exposed to violent events beyond anyone’s control recovered faster from the pain than the other patients.
"This can be explained by the fact that a traffic accident is usually of shorter duration than exposure to childhood violence," he said.
It matters when you receive support
But the duration of the trauma was not the only explanation. According to Siqveland's thesis, having a supportive family member is key to a successful recovery from a traumatic event.
Car crash victims are more likely to find support than victims of sexual assault with its accompanying stigmatisation, he writes.
Siqveland also found that women are most likely to be victims of trauma inflicted by others. They also have a higher risk of PTSD and report more severe pain.
Trauma is not just one thing
Previous research has shown that the incidence rate of adults in Norway living with post-traumatic stress is considerably higher than that of patients with lung cancer or colorectal cancer.
This statistic is very telling, says Siqveland.
"The concept of trauma is very broad. I think it would be interesting for researchers who work in the field to differentiate between various types of trauma," he says.
"Today, some health providers work with pain and others with mental health. But this study shows that there’s a big overlap here,” says Siqveland.
Negative experiences become embedded in the body
Negative childhood experiences can also dramatically impact our health, says Dag Øystein Nordanger, a psychologist from the University of Bergen.
Research increasingly shows that patient health is not just about the effects of a bad environment and an unhealthy lifestyle as a result of experiencing trauma early in life, says Nordanger.
“Our entire nervous system is shaped and organised by the experiences we have early in life,” he says.
"You could say that the brain goes into survival mode in a challenging childhood situation. It activates a weaker neural mechanism to protect you against later stresses and illnesses. And you become less prepared to deal with various lifestyle diseases,” he adds.
This kind of “toxic stress” is a prevalent topic among professionals in the field. Toxic stress occurs when negative experiences “get stuck in the body."
"We still have a lot to learn about toxic stress, but what seems clear is that living in a mentally stressful environment for a long time leads to a disturbance in the secretion of stress hormones, and that can have a disruptive effect on the areas of the brain that are important for managing feelings and behaviours.
Read more in the Norwegian version of this article at forskning.no