A front-page New York Times article a few years ago highlighted the growing number of veteran suicides, many resulting from post-traumatic stress disorder. Headlined “After Combat, Victims of an Inner War,” the coverage included several video interviews with veterans unable to piece their civilian lives back together: A sergeant likened PTSD to “shockwaves through my soul,” and an army photographer described her unrelenting depression. In her interview she linked the severity of her PTSD to childhood trauma, in her case, sexual abuse.

As a psychotherapist, I admired her insight into the lifelong impact of childhood trauma, which can reverberate throughout a lifetime.

In my practice, I’ve seen childhood trauma reactivated years into adulthood by varying types of duress, from car accidents to physical and emotional abuse, to family dysfunction and abandonment to natural disasters. Why does trauma linger in our lives, never fully healing in many people? The answer lies in the impact of traumatic experience on the brain. Traumas in early childhood can resurface throughout life because they cause a “shut down” of the frontal lobe, the part of the brain responsible for reasoning. As a result, rational thought — from decision making to problem solving — is compromised. If the trauma is not addressed appropriately at the time it occurs, the brain creates a sort of template for trauma. When severe stress hits, it triggers the unresolved trauma within, and a person becomes re-traumatized, unable to find emotional safety and well-being.

Trauma isn’t simply a feeling of distress. It’s a physical response to an assault. Its victims are often unable to regulate their emotions, overcome setbacks and can resort to drug and alcohol abuse or even suicide in a desperate attempt at psychic pain management. The severity of trauma now receives far more recognition as lessons from the battlefield have trickled into civilian life. For example, after highly stressful incidents — like school shootings — grief counselors are immediately brought in to mitigate the effects of trauma.

Because of the complexity of the human brain, we experience stress through emotional as well as physical assaults. Mere words can activate a full “fight-or-flight” response including adrenaline and cortisol release and the shutting down of the frontal lobe. This is especially true in children, who depend on the benevolence of the adults around them for their wellbeing, and who perceive torrents of angry words as a threat to their survival.

Without minimizing the horrific trauma of veterans of war, I believe that trauma in subtler forms can still devastate the human psyche. Just listen to Jay-Z’s descriptions of his childhood in a Brooklyn housing project to understand how the term “battlefield” can be applied to civilian life. In beings as complex as humans, battlefields both literal and figurative challenge us to process and manage stressful live events we read as “danger.” If our psychic foundation is weakened by “stress fractures,” from childhood, the inner war proves much harder to win.

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