While common reactions have been noted, all reactions to trauma are normal since sexual and power-based violence affect everyone differently; prior experiences will interact with all of the other intimate elements that make up an individual including both their biology and social circumstances. One way to conceptualize the the experience of hypo and hyper arousal that are often felt as a result of a traumatic event and can be referred to as the “window of tolerance” (Ogden, Minton & Pain, 2006, p. 27). The two extremes of “hyper” and “hypo” arousal exist, and then between them is the “optimal arousal zone” where people are able to “receive and integrate information from both internal and external environments.” In tandem, within this optimal arousal zone, “physiological and emotional arousal can be processed” (p. 27). The level of “arousal” someone experiences “naturally fluctuates” due to the surrounding environment as well as what the individual is experiencing “internally.” In addition, every individual has a “habitual width” of their window of tolerance which “influences their overall ability to process information.” For example, people with a “wide range” can “cope with greater extremes of arousal” and “can process complex information.” In contrast, people with a more “narrow window” can experience “fluctuations as unmanageable and dysregulating” (Ogden, Minton & Pain, 2006, p. 28).
THE IMPACT OF TRAUMA ON AROUSAL AND THE WINDOW OF TOLERANCE
When someone “perceives safety,” they can “readily engage with the environment.” However, this engagement cannot take place if an individual “misinterprets environmental cues as dangerous.” Survivors that are struggling with “trauma-related disorders” including Posttraumatic Stress Disorder (PTSD) may have a “functional loss of the fine-tuning that enables positive environmental and social interaction to regulate heart-rate and viscera without sympathetic or dorsal vagal (parasympathetic) arousal” (Ogden, Minton & Pain, 2006, p. 33). In consonant, people who have experienced trauma can become “sensitized by past traumatic events” which can have a significant effect on their “window of tolerance” and can cause them to have “very low thresholds for relatively minor stressors, responding with extreme arousal...either becoming hyper-aroused or becoming hypo-aroused.” Hence, “because the window of tolerance has become functionally narrowed by repeated traumatic responses” someone can become “increasingly more vulnerable to perceived traumatic triggers” (Ogden, Minton & Pain, 2006, p. 34). Many survivors are “unable to prevent wide swings of dysregulated arousal” and oscillate between hypo-arousal and hyper-arousal while not spending very much time in the optimal arousal zone (p. 34).
Feeling “too hyper-aroused” can make daily life challenging. Being consistently hyper-aroused can include a “fragmentation of perceptual experience into emotional and/or sensory elements - flashbacks, nightmares and contribute to rapid heart rate, elevated blood pressure, and altered skin conductance”(Ogden, Minton & Pain, 2006, p. 34). In addition, constantly living in this state has the potential to “impair overall ability to make adaptive choices” where someone might “have difficulty using emotions as signals from which to make meaning” (p. 34). With hyper-arousal, “the intensity and accelerated pace of emotions, sensations, and sensory stimuli can disrupt reasoning and the ability to engage in reflective ‘reality checks.’” In consonant, “hyper-arousal can cause traumatized people to be unable to trust their bodily sensations which can alert them to take appropriate action. Thus, someone who is frequently hyper-aroused can have a difficult time “responding adaptively” to different situations” (Ogden, Minton & Pain, 2006, p. 34).
Hypo-arousal can sometimes cause “losses in memory, motor or affective function, and somatosensory awareness as those that occurred during the trauma” (Ogden, Minton & Pain, 2006, p. 35). The hypo-arousal state can frequently involve “somatoform dissociative symptoms such as motor-weakness, paralysis, numbness of inner body sensation, confusional states, and deficits in attention” (p. 35). Survivors who are caught in a frequent hypo-aroused state sometimes report a “subjective sense of separation from the body, an absence of sensation in parts of the body (or even in the entire body), and delayed or weakened physical responses.” Ultimately, this can dwindle someone’s ability to “sense emotions and experience emotional reactions to significant events” which can adversely affect the capacity for “emotional processing.” In addition, “cognitive processing” can also be difficult because hypo-arousal states “interfere with the ability to think clearly and hinders appropriate evaluation of dangerous situations” (Ogden, Minton & Pain, 2006, p. 35).
THE ORIENTING RESPONSE
Some survivors, even long after the trauma has occurred, “may find themselves compelled to anticipate, orient to, and react to stimuli that directly or indirectly resembles the original traumatic experience or its context.” While some individuals may “unconsciously and reflexively narrow the field of consciousness to reminders of the trauma and fail to perceive cues indicative of safety,” some may experience “hypo-related interference” and may find it incredibly difficult to “orient to cues signaling either pleasure or danger” (Ogden, Minton & Pain, 2006, p. 65). According to Siegel (2012), “physical and psychological responses to both internal and external stimuli are predicated on, and extrapolated from orienting responses - what we turn our attention to, or orient to, determines not only our physical actions but our mental actions as well...this preparation is both physical and psychological” (p. 65). “Orienting” takes place on both an “overt and covert level.” Overt orienting includes “visible physical actions of turning, particularly the eyes and often the head and the body, in the direction of an environmental stimulus.” In contrast, covert orienting “does not require muscular change; instead, an ‘inner’ or ‘mental’ shift in attention from one environmental stimulus to another” takes place (Siegel, 2012, p. 66). People who have experienced trauma may struggle with “synchronizing overt and covert orienting” which means they might “overtly orient to everyday stimuli while covertly orienting toward trauma-related stimuli” (p. 67). Survivors of sexual and power-based violence may have difficulty “sorting out relevant significant cues” from insignificant ones. Their own personal selection process might be “biased by hypo-arousal states and a corresponding dulling of the senses that interferes with the ability to select and orient to relevant cues.” Conversely, a “felt sense of danger and the accompanying hyper-arousal may make trauma-related stimuli the dominant objects of their orientation” (Siegel, 2012, p. 68). Survivors of sexual and power-based violence, dysregulated orienting tendencies can include a “hypersensitivity to minor environmental or internal changes, a tendency to over-orient to trauma-related stimuli, and an inability to discriminate and evaluate the context of stimuli, especially regarding cues that may indicate danger in certain contexts but not in others” (Siegel, 2012, p. 70). As stated in the previously published article”The Anatomy of Trauma,” the “re-experiencing” phenomena can be brought on by “internal-thoughts, physical sensations,” and “external cues” which “symbolize or resemble” a piece of the traumatic event. External triggers that can evoke flashbacks and anguish are very “individual specific” and can include “places, items of clothing, accents, colors, smells, or time of day” (Doyle & Thorton, 2002, p. 110). “Adaptive attention” enables people to have an “active balance between being too distracted, unfocused, erratic, or flighty and being overly focused, compulsive, obsessive, or fixated.” However, cultivating this “dynamic equilibrium is particularly difficult for traumatized people, whose arousal is often not within the window of tolerance” which means being too “hyper or hypo” aroused. In order to strengthen one’s attention, it is important for arousal to be “fairly high, toward the upper limits of the window of tolerance, but not so high that it interferes with concentration” (Siegel, 2012, p. 73-74).
The trauma of a sexual assault sometimes can affect a survivor’s sexuality as well as their physical, mental, and emotional health. For example, many survivors of sexual violence experience a change in their sexual habits and behaviors - this may include a change in desire levels, or perhaps preferred sexual activities. When the trauma experienced involves sex, “factors related directly to the assault may interfere with normal sexual response” (Foley, Kope & Sugrue, 2012, p. 219-220). If a survivor “experienced arousal and even orgasmed during the abuse, this may leave them feeling ashamed that their bodies responded sexually and sometimes, this confusion and shame often spill into future sexual situations” (Foley, Kope & Sugrue, 2012, p. 220). Of course, if the body experiences a sexual response, this is in no way indicative of the survivor wanting to engage in the sexual behavior. Survivors of sexual trauma who are in a constant state of hyper-arousal, may find “relaxation during sexual activity” very difficult. In fact, “sex and pleasure may significantly fall by the wayside” (Foley, Kope & Sugrue, 2012, p. 218-219). Likewise, many people who have been sexually assaulted find that they have “little or no interest in sex.” This behavior could result immediately after the assault, or not manifest until weeks, months, or years later (p. 222). In other cases, many survivors of sexual trauma may “not simply lose their interest in sex,” but rather become “disgusted and frightened by anything sexual.” This can also be referred to as “sexual aversion” which is described as a “phobic reaction that can be traced back to earlier trauma and because of the trauma, sexual cues trigger a strong emotional reaction” (Foley, Kope & Sugrue, 2012, p. 223). Conversely, survivors can sometimes experience an increase in sexual desire which can sometimes translate into an attempt to “overcome feelings of powerless or exploitation” that were felt during the time of the assault (p. 226).
Doyle, A.M., & Thorton, S. (2002). Psychological assessment of sexual assault. In J. Petrak & B. Hedge (Eds.), The trauma of sexual assault (pp. 99-134). New York, NY: John Wiley & Sons, LTD.
Foley, S., Kope, S.A., & Sugrue, D.P. (2012). Sex matters for women: A complete guide to taking care of your sexual self. New York, NY: The Guilford Press.
Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. New York, NY:
W.W. Norton & Company. Siegel, D.J. (2012). The developing mind: How relationships and the brain interact and shape who we are (2nd ed.). New York, NY: The Guilford Press.
* Picture taken from: http://www.bostoneveningtherapy.com/2013/06/the-window-of-tolerance-edge...