The Biology of trauma

The Biology of Trauma is the title of a recently published book by Dr. Aimie Apigian MD, and it has also been the central theme of my own professional work over the past two decades. In essence, our life experiences are expressed in our physiology, good and bad. What happens to us shapes our biology, not just our emotions or beliefs. Dr. Aimee’s book builds on an expanding body of research and clinical insight showing that difficult, overwhelming experiences can lead to chronic health conditions such as autoimmune diseases and inflammatory syndromes.

She is the latest prominent voice to join a growing movement of physicians, among them Dr. Gabor Maté, Dr. Bessel van der Kolk, and Dr. Daniel Siegel, who are reframing trauma not as a purely psychological problem, but as a biological adaptation. Their hopeful message enables an understanding of how trauma takes root in the body, and thus also learn how to heal it.

The theory

Trauma, when stripped of its dramatic associations, can be understood simply as the body system becoming overwhelmed. It isn’t necessarily about what happens to us, but about what happens inside us as a result. Two people might live through the same event—one emerges shaken but resilient, while the other develops chronic anxiety, pain, or illness. The difference lies in biology, not willpower.

Dr. Apigian offers a compelling way to understand what causes overwhelm:

·      “Too much, too fast”—the body is flooded by an event that exceeds its capacity to cope, such as a car accident, a sudden loss, or a violent encounter.

• “Too little, for too long”—a prolonged lack of safety or support, such as ongoing neglect, chronic stress, or emotional abuse.

In both cases, the nervous system shifts into survival mode. The body prioritises safety over growth, vigilance over rest, and protection over connection. Over time, this can rewire our physiology. Hormones, immune responses, digestion, and even gene expression can be affected. We become stuck in patterns of hyperarousal (fight-or-flight) or hypoarousal (freeze or collapse).

Dr. Apigian describes this as the biology of trauma, a state in which the body’s survival responses never fully switch off.

Stories from the body

The power of this theory becomes real when we see it lived out.

A client, a successful executive, came to me with chronic fatigue and anxiety. She described her life as “constantly firefighting.” Her adult nervous system continued a pattern formed in childhood in a volatile household, where she learned early that calm could be shattered at any moment. Her internal alarms kept ringing even when her external world was safe. Through somatic-oriented bodywork for nervous system regulation, she gradually returned to a healthier, calm, energised rhythm.

Another client, a small business owner, suffered from autoimmune flare-ups that defied medical explanation, but which impacted her business. Tracing her health history alongside her life experiences, a clear pattern emerged of fear and appeasement. Each major flare followed a period of conflict and relationship breakdown. Her symptoms eased not by talking about the past, but by teaching her body that it was no longer in danger. She described the process as “coming home to myself.”

These stories illustrate a profound truth: our bodies keep the score, as Bessel van der Kolk famously wrote. They record every unprocessed shock, every moment of helplessness, every long stretch of tension. And unless we learn to read that language, we may continue to chase symptoms without resolving the root cause.

The way forward

Healing is not a linear process, and often there is no quick fix for an overwhelmed body system. However, there is enormous potential for recovery when we work with the body rather than against it.

The key is regular somatic practices and somatic-oriented therapies which support the nervous system to relearn safety through physical experience rather than intellectual insight. This might begin simply with embodiment coaching, breathwork, mindful movement, and learning to release physical tension.

For those in high-pressure professions, burnout, exhaustion, and chronic stress are not moral failings but biological signals that our systems are out of balance. Learning to listen to these signals is both a personal and professional act of wisdom.

Understanding the biology of trauma provides a roadmap for a healthier, more sustainable way of living and leading. In a world moving ever faster, perhaps the most revolutionary act is to slow down, shake off our appeasement shackles, and find our own rhythm again.

Ref: Apigian, A (2025) The Biology of Trauma. BenBella Books, Inc: Dallas, TX

Firt published in Ambition Magazine Dec 2025