SYMPATHETIC NERVOUS SYSTEM (SNS)  
Division of the ANS, primarily aroused in states of stress, both positive and negative. Signs of SNS arousal include increased heart rate and respiration, cold and pale skin, dilated pupils, raised blood pressure.

PARASYMPATHETIC NERVOUS SYSTEM (PNS) 
Division of the ANS, primarily aroused in states of rest and relaxation. Signs of PNS arousal include decreased heart rate and respiration, warm and flushed skin, normally reactive pupils, lowered blood pressure.

HYPERAROUSAL 
Refers to extreme, persistent activation in the ANS.

LIMBIC SYSTEM 
The Limbic System of the brain responds to extreme stress/trauma/threat by releasing hormones that tell the body to prepare for defensive action, activating the SNS, preparing the body for fight or flight: increasing respiration and heart rate, sending blood away from the skin and into the muscles, etc. When death is imminent or the threat is prolonged (as with torture, rape, etc.), the brain can also release hormones to heighten the PNS, and TONIC IMMOBILITY can result (Gallup 1977).

TONIC IMMOBILITY 
ANS reaction to extreme threat. Simultaneous SNS and PNS hyperarousal. PNS hyperarousal masks/puts a lid on the SNS hyperarousal and the body freezes - like a mouse going dead (slack) or a frog or bird becoming paralyzed (stiff) (Gallup 1977). Often the mechanism behind inability to run or fight back.

STRESSOR 
Any emotional or physical demand (positive or negative) that gives or results in STRESS. STRESS "For scientific purposes, stress is defined as the nonspecific response of the body to any demand [STRESSOR]. It was first recognized by evidence of adrenal stimulation, shrinkage of lymphatic organs, gastrointestinal ulcers, and loss of body weight with characteristic alterations in the chemical composition of the body." (Selye 1984). Stress produces activation in the SNS. It is generally regarded as a response to a negative experience, but stress can also result from positive experiences: e.g., marriage, job change, moving, sex, etc.

TRAUMATIC EVENT 
Event that is or is perceived as threatening to one's own or a close associate's life or physical integrity. Examples: War, disaster, car accident, rape, assault, operation, molestation, loss of significant other (child, spouse, parent).

EMOTIONAL SHOCK 
Reaction to a TRAUMATIC EVENT. In conversation, many informally use the term SHOCK instead of TRAUMA, but in the professional literature, TRAUMA is used exclusively to refer to reactions to TRAUMATIC EVENTS.

TRAUMA 
A psychobiological reaction to a TRAUMATIC EVENT. Characterized by hyperarousal of the SNS, and with extreme threat, possibly also activating the PNS. Not all TRAUMATIC EVENTS lead to TRAUMA in all people. Figley (1985) suggests that TRAUMA is "an emotional state of discomfort and stress resulting from memories of an extraordinary, catastrophic experience which shattered the survivor's sense of invulnerability to harm." "TRAUMA" is often used erroneously to refer to stressful events of any kind. It is important to differentiate between stress that results from threat to life and bodily integrity, and stress that results from less dramatic incidents. (See "DEVELOPMENTAL AND LIFE DISTRESS" below)

TRAUMATIC STRESS 
Psychobiological reaction to a TRAUMATIC EVENT involving hyperarousal of ANS and the reflexes of fight, flight, freeze, and/or dissociation.

POST-TRAUMATIC STRESS (PTS) 
TRAUMATIC STRESS that has not been relieved through a successful fight or flight, or by a resolution of TRAUMA by other natural or therapeutic means. May be characterized by symptoms of chronic hyperarousal in the ANS, flashbacks, and/or dissociation. PTS does not disrupt general functioning.

POST-TRAUMATIC STRESS DISORDER (PTSD)
(See also: DSM IV, pages 424-429)
TRAUMATIC STRESS resulting from a TRAUMATIC EVENT that has not been relieved through a working through of TRAUMA and is of sufficient severity to decrease a person's ability to function in his life. Characterized, in part, by symptoms of ANS hyperarousal (including sleep disturbance, lack of concentration, hypervigilance, exaggerated startle reflex) and continued activation of the reflexes of fight, flight, freeze, and/or dissociation. Hyperarousal is indication that the TRAUMATIC EVENT is being repeatedly remembered in mind and/or body. In addition there will be avoidance of stimuli associated with the trauma. Acute: if duration of symptoms is less than 3 months. Chronic: if duration of symptoms is three months or more. Delayed Onset: if onset of symptoms is at least 6 months after the stressor. Can include reaction in adulthood to a TRAUMATIC EVENT that occurred in childhood. (American Psychiatric Association 1994)

ACUTE STRESS DISORDER 
Occurs within 1 month following a TRAUMATIC EVENT. Similar etiology, symptoms and course as PTSD, but of limited duration - 2 days to 4 weeks. (American Psychiatric Association 1994)

SIMPLE PTSD (SINGLE AND MULTIPLE NON- CHAINED) 
PTSD resulting from a single standing TRAUMATIC EVENT, not linked in any way to any other(s), e.g., one rape, one automobile accident, one sudden loss, etc. Sometimes referred to as "Type I."

CHAIN TRAUMA 
"Chain shock" is a term coined at the BODYnamic Institute to describe PTS or PTSD resulting from a combination of 2 or more TRAUMATIC EVENTS linked by theme, timing or other factors (Jørgensen 1992). CHAIN TRAUMAS can include repeated sexual or physical assaults, serial losses, or seemingly unrelated TRAUMATIC EVENTS linked by psychological themes, such as, "it's not safe to be myself", responsibility, abandonment, etc.

COMPLEX PTSD 
"A history of subjection to totalitarian control over a prolonged period (months to years). Examples include hostages, prisoners of war, concentration camp survivors and survivors of some religious cults. Examples also include those subjected to totalitarian systems in sexual and domestic life, including survivors of domestic battering, childhood physical or sexual abuse, and organized sexual exploitation." (Herman 1992) COMPLEX PTSD is usually a reaction to a combination of specific TRAUMATIC EVENTS within a context of CHRONIC STRESS. Isolation appears to be an important element. Sometimes referred to as "Type II." Borderline Personality Disorder, Dissociative Disorders and other classes of severe mental illness may have their roots in COMPLEX PTSD and/or CHAIN TRAUMA.

CHRONIC STRESS 
A psychobiological condition that can resemble PTSD. It results not from single or multiple TRAUMATIC EVENTS, but from an environment, life style or chronic situation that is constantly and extremely emotionally stressful (and possibly physically stressful): e.g., serious long illness of self or significant other (spouse, parent, child), certain kinds of strict or neglectful childhood environments, dysfunctional relationships or family environments, financial hardship, etc. Situations such as child abuse, incest, captivity and torture may best be understood as CHAIN TRAUMAS within a context of CHRONIC STRESS.

DEVELOPMENTAL AND LIFE DISTRESS 
Stress resulting from significant and disturbing, but not life-threatening events occurring throughout life. Such stressful events may include: chronic illness, narcissistic parenting, family dysfunction, school adjustment, peer group problems, marital problems, job issues, etc.

DISSOCIATION 
A psychological state whereby the memory of an event is divided into individual parts which are not wholly, or partially accessible to consciousness at any one time. (Braun 1988, Levine 1997)

TRIGGER
Any environmental or internal cue that serves as a reminder of a TRAUMATIC EVENT - either directly or through a chain of associations -, causing hyperarousal in the ANS and preparation for fight/flight/freeze as if the event were occurring now. ANS hyperarousal can itself be a TRIGGER - elevated heart rate or respiration from, e.g., caffeine, physical exertion, medication, etc. - setting off TRAUMA.

FLASHBACK 
A common, though not always present, symptom of PTSD. "In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at the moment (DSM IV)." During a FLASHBACK the ANS prepares the body for fight/flight/freeze as if the event were occurring now. FLASHBACKS can be visual, auditory, behavioral and/or sensory.

References

American Psychiatric Association (APA), DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, Forth Edition, 1994.

Braun, Bennett G., M.D., "The BASK Model of Dissociation", Dissociation, 1:1, March 1988.

Figley, Charles R., Ph.D., TRAUMA AND ITS WAKE, Volume I: The Study and Treatment of Post-Traumatic Stress Disorder, Brunner/Mazel, 1985.

Gallup, Gordon G., Jr., and Maser, Jack D., "Tonic Immobility: Evolutionary Underpinnings of Human Catalepsy and Catatonia", in Seligman, Martin E. P., and Masser, Jack D., PSYCHOPATHOLOGY: EXPERIMENTAL MODELS, San Francisco: W.H. Freeman and Company, 1977.

Herman, Judith L., MD, TRAUMA AND RECOVERY, Basic Books, 1992.

Jørgensen, Steen, Cand. Psych., "Bodynamic Analytic Work with Shock/Post-Traumatic Stress", Energy and Character, Vol. 23, No. 2, September 1992.

Levine, Peter, Ph.D., WAKING THE TIGER, 1997

Rothschild, Babette, M.S.W., "Defining Shock and Trauma in Bodypsychotherapy, Energy and Character, Vol. 26, No.2, September 1995.

Selye, Hans, M.D., THE STRESS OF LIFE, McGraw-Hill Book Co., 1984.