How trauma lives in the body

Body and mind

Some effects of childhood abuse are easy to connect to the past, like nightmares or anxiety. Others, like stomach problems or feeling "not really there," are harder to link. Many survivors never make the connection on their own.

In short

Childhood sexual abuse is a strong risk factor for anxiety disorders, especially PTSD, in men and women alike.
Dissociation, feeling numb or detached, started as a child's way to survive and can keep switching on in adulthood.
Many survivors have a painful relationship with their own body.
Gut problems like IBS are more common in people who lived through trauma.

It can help to see these as connected, rather than four separate problems:

What you might notice	What may be happening
Always on edge, worried, jumpy	His nervous system is still set for danger that's no longer there.
Seems numb, far away or "checked out"	His mind is disconnecting to protect him, as it learned to in childhood.
Uneasy with his body, touch or compliments	The abuse changed how he relates to his own body.
Stomach or gut trouble, chronic pain	His body is carrying stress that his mind has pushed away.

Anxiety and PTSD

A large review covering 171 studies and more than 3 million people found that childhood sexual abuse is a significant risk factor for anxiety disorders, and especially for PTSD. This held true for men and women alike, and whether the abuse was more or less severe.

The researchers note that abuse is usually one of several factors, working together with biology, family life and other experiences. It's not the only cause, but it matters.

Dissociation: feeling "not really there"

Dissociation means disconnecting from your senses, feelings, thoughts, memories or sense of self. For a child who can't escape abuse, it's a way to survive: if you can't leave physically, your mind leaves instead. One trauma treatment organization estimates that childhood trauma is the root cause for at least 90% of people who dissociate.

It ranges from mild to severe:

Milder: feeling emotionally numb, or like you're living behind a pane of glass.
More severe: feeling outside your own body, feeling like the world isn't real, or losing chunks of time and memory.

The problem is that the brain can keep using this escape under stress long after the danger is over. It can affect relationships, work and intimacy. If he seems to "go somewhere else" during conflict or closeness, this may be why. It isn't a choice to shut you out.

His relationship with his body

Survivors of childhood sexual abuse often have a hard relationship with their own bodies. Common experiences include:

Feeling like his body doesn't really belong to him.
Feeling shame about his body, including blaming it for how it reacted during the abuse.
Constant dissatisfaction with how he looks.
Staying disconnected from physical sensations as a habit.
Mixed or upsetting reactions to compliments or sexual attention.
Seeing his body as disgusting, or as only useful for sex.

You may have heard of body dysmorphic disorder (BDD). Research suggests BDD is more strongly tied to emotional abuse and neglect than to sexual abuse specifically. The broader body image struggles above are the more typical pattern for sexual abuse survivors.

Gut problems and IBS

A Mayo Clinic study of more than 2,600 people found that childhood abuse was reported by up to half of people with irritable bowel syndrome (IBS), about twice the rate of people without it. Other life traumas, like losing a loved one or going through a divorce, were also common.

As one Mayo Clinic researcher put it, "Trauma may sensitize the brain and the gut." In other words, the link is physical, not "all in his head." If he has ongoing gut problems, it's worth knowing that trauma can play a part.

What helps

Because these effects live in the body as well as the mind, some survivors do well with body-based therapy such as Somatic Experiencing, alongside or instead of talk therapy. Therapists with training in trauma and dissociation can help too. See Find help for what to look for.

Next: Coping and compulsions →