In my years of clinical practice working with trauma survivors, I’ve come to understand that trauma is not just a psychological experience—it’s a whole-body experience that fundamentally affects how our nervous system functions.
Trauma and the Nervous System: A Complete Guide to Understanding Your Body’s Stress Response
TRAUMA RECOVERY • March 15, 2026
SUMMARY
Your nervous system has been keeping score for years — maybe decades. This guide explains what actually happens in your body when trauma gets stored there: the polyvagal ladder, the window of tolerance, fight/flight/freeze/fawn, somatic memory, and why hypervigilance isn’t a character flaw but a survival adaptation. You’ll also find the evidence-based approaches that support real nervous system healing, explained in plain terms for driven women who want to understand what’s happening beneath the surface.
It’s a Tuesday evening in November. Camille is sitting in her car in the parking garage of her downtown office, engine off, hands in her lap. The performance review she just finished went well — glowing, actually. Her manager used the word “exceptional.” She got the raise. She’s been working toward this exact moment for eighteen months.
And she can’t stop shaking.
Not trembling. Shaking. Hands. Jaw. A full-body vibration she doesn’t have a name for. Her chest is doing something uneven. The yellow fluorescent light of the garage feels physically unbearable — too bright, too harsh, pressing in. She turns the car on just to have something to do, and sits there for twenty-two minutes before she can make herself drive home.
She doesn’t tell anyone. She tells herself it was the stress of the year, the coffee she had too late, maybe the beginning of something medical. But when she describes it in my office a few weeks later — three sessions in, just starting to trust the room — she says something I’ve heard from dozens of clients in different forms: “My mind knew I was fine. My body didn’t get the memo.”
That gap — between what your mind knows and what your body does — is one of the clearest signatures of a nervous system that’s been operating in survival mode for a very long time. It’s not weakness. It’s not drama. It’s the predictable, intelligent result of a nervous system that learned, somewhere along the way, that the world wasn’t reliably safe. And it’s doing exactly what it was trained to do.
This guide is for the Camilles. For the driven women whose bodies keep interrupting their lives in ways that don’t make cognitive sense. For the ones who’ve read the books, know the vocabulary, maybe even teach the concepts to others — and are still waking at 3 AM with their hearts pounding, still going blank when someone raises their voice, still unable to fully relax no matter how much they’ve achieved. For anyone who suspects their nervous system may be calibrated for a threat level that doesn’t match their actual life anymore.
Let’s look at what’s actually happening.
What Is the Trauma Response?
The first thing to understand — and this matters more than almost anything else I’ll say in this post — is that trauma is not what happened to you. Trauma is what happened inside your nervous system in response to what happened to you.
This distinction, articulated by Bessel van der Kolk, MD, psychiatrist and trauma researcher and author of The Body Keeps the Score, fundamentally changed how clinicians think about trauma treatment. It means that the same event can be traumatic for one person and not for another, depending on the state of their nervous system at the time, their developmental history, their access to support, and dozens of other factors. It also means that the path to healing runs through the body — not just through insight or understanding.
Trauma, in clinical terms, is any experience that overwhelms the nervous system’s capacity to process and integrate it. It doesn’t have to be a single catastrophic event. In my work with clients, I see far more nervous systems shaped by what I think of as cumulative trauma — the slow accumulation of relational wounds, chronic stress, emotional neglect, unpredictability, or marginalization over time. The nervous system that grew up in a household where a parent’s mood was unpredictable, or where a child’s needs were consistently minimized, or where safety depended on reading the room perfectly — that nervous system develops a particular kind of expertise. It becomes exquisitely attuned to threat. And it doesn’t easily forget.
DEFINITION
TRAUMA RESPONSE
The trauma response is the nervous system’s automatic, non-volitional activation in response to perceived threat — characterized by a cascade of neurobiological changes including cortisol and adrenaline release, increased heart rate, muscle tension, sensory narrowing, and the suppression of higher cognitive functions. Bessel van der Kolk, MD, psychiatrist, trauma researcher, and author of The Body Keeps the Score, has demonstrated through decades of research that traumatic memories are stored differently than ordinary memories — encoded in the body’s sensory systems rather than in the brain’s verbal narrative centers, which is why they resurface as physical sensations, emotional floods, or behavioral responses rather than coherent stories.
In plain terms: When you freeze in a meeting, go completely blank when confronted, or find yourself shaking after something that “shouldn’t” be a big deal — that’s not weakness. That’s your nervous system running a program it wrote years ago, in a different context, to keep you safe. It’s doing its job. The problem is that the job description is outdated.
This is also why talk therapy alone often isn’t enough for trauma recovery. When the nervous system is activated, the brain’s verbal processing centers — Broca’s area, the prefrontal cortex — actually go offline. This is why trauma survivors so often find themselves unable to articulate what’s happening mid-episode: the part of the brain that does language has temporarily been overtaken by the parts that are managing survival. Understanding trauma requires working with the body, not just the mind.
Understanding the long-term effects of childhood emotional neglect often begins here — with recognizing that the nervous system formed its core patterns in those early relational environments. And if you’re curious whether your nervous system patterns trace back to relational wounds, Annie’s free quiz can help you identify the childhood wound most quietly shaping your adult life.
The Neurobiology of Trauma: Fight, Flight, Freeze, Fawn, and the Polyvagal Ladder
Most people have heard of fight or flight. Fewer know about freeze. Even fewer understand fawn — or the neurological framework that explains why all four responses exist and why you can’t simply decide not to have them.
The foundational framework here is Polyvagal Theory, developed by Stephen Porges, PhD, Distinguished University Scientist at Indiana University, research scientist at the Kinsey Institute, and creator of Polyvagal Theory. Porges’s work, published most accessibly in The Polyvagal Theory (2011) and popularized by practitioners like Deb Dana, proposed something genuinely revolutionary: the autonomic nervous system doesn’t just have two states (stressed vs. relaxed). It has three distinct states, organized hierarchically, and each one governs an entirely different way of being in the world.
DEFINITION
POLYVAGAL THEORY
Polyvagal Theory, developed by Stephen Porges, PhD, Distinguished University Scientist at Indiana University and creator of Polyvagal Theory, proposes that the autonomic nervous system operates through three hierarchically organized states: (1) Ventral Vagal — the social engagement system, activated when the nervous system registers safety; (2) Sympathetic — the mobilization system, activated when threat is perceived and fight or flight is possible; and (3) Dorsal Vagal — the immobilization system, activated when threat is perceived as inescapable and shutdown or freeze is the adaptive response. Porges demonstrated that these states are governed by distinct branches of the vagus nerve and produce predictable, measurable physiological signatures.
In plain terms: Think of your nervous system as a ladder with three rungs. At the top: you feel safe, connected, curious, warm. You can think clearly. In the middle: your heart’s pounding, you’re on edge, ready to act — fight or flee. At the bottom: you’re shut down, numb, disconnected, maybe dissociating. Trauma doesn’t just push you down the ladder once — it recalibrates where the ladder starts.
Here’s how the four trauma responses map onto this framework:
Fight is sympathetic activation directed outward. Anger, aggression, confrontation — the nervous system mobilizing to remove the threat. In driven women, this often looks like irritability that feels disproportionate, snapping at people they love, or an intensity in conflict that frightens them afterward.
Flight is sympathetic activation directed inward — or more accurately, away. Anxiety, hypervigilance, constant motion, workaholism, perfectionism, the inability to sit still. In my work with clients, the women who are most visibly productive are sometimes the ones most deeply in a chronic flight state. Busy-ness is an excellent hiding place from a nervous system that can’t tolerate stillness.
Freeze is dorsal vagal shutdown. The system decides the threat is inescapable and conserves resources by going offline. This looks like dissociation, emotional numbness, going blank, freezing in conflict, depression that feels like a fog rather than sadness. It can feel like being stuck in amber — you can see your life but can’t quite reach it.
Fawn — coined by therapist Pete Walker, LMFT, author of Complex PTSD: From Surviving to Thriving — is the people-pleasing, appeasement response. The nervous system learns that the safest survival strategy is to manage the emotional states of others: becoming what they need, shrinking to avoid conflict, abandoning your own needs to keep the peace. Many of the driven, ambitious women I work with spent their childhoods fawning their way to relative safety — and are still doing it decades later in their marriages, their professional relationships, and their own heads.
Peter Levine, PhD, developer of Somatic Experiencing and author of Waking the Tiger: Healing Trauma, has noted that in animals, the freeze response is followed by a natural discharge — shaking, trembling, running — that metabolizes the stored survival energy. In humans, particularly those raised in environments where emotional expression was unsafe or unwelcome, this discharge gets suppressed. The survival energy has nowhere to go. It stays in the body, encoded as tension, pain, hypervigilance, or chronic activation.
This is why understanding intergenerational trauma matters so much: the nervous system responses you experience today may have been shaped not just by your own history, but by the survival adaptations of your parents and grandparents, passed down through early attachment and learned patterns of relating.
The Window of Tolerance: Your Nervous System’s Operating Range
One of the most clinically useful concepts in trauma work — one I return to constantly in sessions — is the window of tolerance, a term coined by Daniel J. Siegel, MD, clinical professor of psychiatry at the UCLA David Geffen School of Medicine and author of The Developing Mind.
DEFINITION
WINDOW OF TOLERANCE
The window of tolerance, a concept developed by Daniel J. Siegel, MD, clinical professor of psychiatry at the UCLA David Geffen School of Medicine and author of The Developing Mind, refers to the zone of nervous system arousal in which a person can function most effectively — processing information, connecting with others, feeling emotions without being overwhelmed by them. Above this window is hyperarousal (anxiety, panic, emotional flooding, hypervigilance); below it is hypoarousal (numbness, shutdown, dissociation, disconnection). Trauma narrows the window, making it harder to stay in the functional zone and easier to be thrown into survival states by everyday triggers.
In plain terms: Everyone has a range where they can function — stressed but handling it. Trauma shrinks that range. What would have been manageable stress becomes overwhelming. What would have been mild disappointment becomes unbearable. The goal of trauma work isn’t to eliminate difficult feelings — it’s to widen the window so you can be with more of life’s texture without being hijacked by it.
What this looks like in practice: a woman with a narrow window of tolerance might be sailing along fine, and then a slightly sharp tone in an email from her boss sends her into four hours of anxiety spiraling. Or she’s in a productive meeting and someone mildly challenges her idea and she goes completely flat, can’t access her thoughts, looks competent on the outside but feels like she’s behind glass on the inside. Or she notices that she can’t tolerate any conflict in her marriage without either exploding or shutting down — there’s no in-between.
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These aren’t personality flaws. They’re the predictable results of a nervous system that developed its baseline calibration in an environment where the window had to be kept very narrow to survive.
The good news — and this is clinically important — is that the window of tolerance can be widened. Not overnight, not through willpower, but through the gradual, consistent, body-based work of nervous system regulation. This is a significant part of what I work on with clients in trauma-informed individual therapy: slowly, safely expanding the range of what the nervous system can tolerate without losing its footing.
Think of it as building a larger container. You’re not becoming less sensitive — you’re becoming more capable of holding what you feel without being overwhelmed by it.
Somatic Memory: How Trauma Lives in the Body
Here is something that surprises most people when they first encounter it: traumatic memories are not stored like regular memories. They’re not filed in the brain’s narrative centers — the regions that process language and sequence and time. They’re stored somatically: in the body’s sensory systems, in muscle tension, in posture, in breath patterns, in the speed of the heartbeat, in the quality of the gaze.
Bessel van der Kolk, MD, psychiatrist, trauma researcher, and author of The Body Keeps the Score, was among the first to document this neurologically. His research, along with that of colleagues like Ruth Lanius, MD, PhD, professor of psychiatry at Western University and director of the PTSD research unit, demonstrated that when trauma survivors are exposed to reminders of their traumatic experiences, the brain’s speech center (Broca’s area) goes offline while the sensory and emotional centers light up intensely. In other words: the body relives while the mind goes silent.
This is why a specific smell can make you feel six years old again. Why a tone of voice can activate a physical response before your mind has consciously registered what’s happening. Why certain textures, sounds, or lighting conditions can shift your entire nervous system state in under a second. Your body is not reacting to the present moment — it’s reacting to a stored memory that lives in its cells.
In my work with clients, I often describe somatic memory as the body’s filing system for experiences that were too overwhelming to be processed through the mind’s normal channels. When something happens that’s too much — too fast, too intense, too helpless — the nervous system essentially takes a snapshot and stores it in the body for later. The problem is that “later” often never comes in the natural course of a busy life. The snapshot stays. And it keeps activating whenever the body perceives something that resembles the original threat.
This has practical implications for daily life. The woman who tenses her shoulders the moment she enters a critical meeting isn’t doing it consciously — her body has associated that physical environment with threat and is bracing automatically. The woman who goes cold and clinical when her partner raises a difficult topic isn’t choosing emotional unavailability — her nervous system has flagged vulnerability as dangerous and is protecting her. The woman who can’t slow down, can’t rest, can’t tolerate silence — her body may have learned that stillness was where the worst things happened.
Understanding somatic memory also explains why nervous system healing requires body-based approaches. You can’t think your way out of a body-held memory. You can, however, help the body complete what it started — and this is where approaches like Somatic Experiencing, EMDR, and trauma-sensitive yoga become so valuable. These aren’t alternative or fringe treatments; they’re evidence-based modalities that work directly with the nervous system’s own language. Learn more about the specific approaches that can help in Fixing the Foundations, Annie’s signature course for trauma recovery.
How Nervous System Dysregulation Shows Up in Driven Women
Priya is a 38-year-old pediatric cardiologist. She’s been in practice for nine years, has a reputation for being unflappable in the OR, runs three miles before rounds most days, and is the person everyone in her family calls in a crisis. She came to therapy because she couldn’t sleep. Specifically: she could fall asleep fine, but she’d wake between 2 and 4 AM and be unable to fall back asleep, mind racing through patient cases, logistical worries, half-finished to-do lists that felt urgent in the dark.
She’d had this pattern for eight years. She’d tried melatonin, sleep hygiene, cutting caffeine, white noise machines. Nothing stuck. And when I asked her when the last time was that she’d felt genuinely at ease — not accomplished, not finished, not checked-out-via-alcohol, but actually at ease — she went quiet for a long moment.
“Maybe never,” she said. “Or I was really young.”
That answer — “maybe never” — tells me something specific about the nervous system. It tells me that the window of tolerance may have been narrow for a very long time. It tells me that what reads as high-functioning, driven, capable may also be a nervous system that never fully learned to downregulate — to come back to rest after activation.
In my clinical experience, nervous system dysregulation in ambitious, driven women tends to manifest in a cluster of patterns that often get misread as personality traits or lifestyle choices. What I see consistently:
Chronic hypervigilance that looks like conscientiousness. She’s always prepared, always thinking three steps ahead, always monitoring the room for what might go wrong. This is exhausting — but it’s been working for her professionally, so she’s had no reason to question it. The problem is that hypervigilance never turns off. It’s running 24/7, even when the situation doesn’t require it.
Inability to rest without guilt. Taking a Saturday afternoon to genuinely do nothing feels intolerable — not because she doesn’t want rest, but because her nervous system registers stillness as a threat. Resting feels dangerous in some pre-verbal, bodily way. Productivity has become a regulation strategy: if she’s busy, she can’t feel what’s underneath.
Emotional flooding or emotional flatness. Her window of tolerance is narrow. Either she’s numb and distant (hypoarousal) or she’s overwhelmed by feelings that seem disproportionate to the situation (hyperarousal). There’s very little comfortable middle ground.
Physical symptoms without clear medical cause. Chronic tension headaches. GI issues. A tight chest. Jaw clenching. These are the body’s way of carrying the nervous system’s ongoing activation. The body can’t sustain chronic stress activation without translating it into physical experience.
Relationship patterns that mirror survival strategies. The fawning that helped her survive an unpredictable parent now shows up as difficulty saying no to clients, resentment toward a partner she can’t ask for help, an exhausting attunement to everyone’s emotional states except her own. Understanding these patterns is often the focus of trauma-informed executive coaching — which addresses the nervous system piece alongside the professional piece.
None of these are character flaws. They’re adaptations. They were intelligent. They were survival strategies that worked. The question, in trauma work, is: do they still need to work this hard? And the answer, for most of the women I work with, is: not anymore. But the body doesn’t know that yet.
“The body keeps the score: if the memory of trauma is encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal/muscular problems, and if mind/brain/visceral communication is the royal road to emotion regulation, this demands a radical shift in our therapeutic assumptions.”
Bessel van der Kolk, MD, Psychiatrist and Trauma Researcher, Author of The Body Keeps the Score
Both/And: You Adapted Brilliantly — And You’re Still Paying for It
One of the most important framings I return to in this work — and in my writing — is what I call the Both/And. It’s a refusal to collapse complexity into a single narrative, and it’s especially important when it comes to trauma and the nervous system.
The Both/And here is this: Your nervous system adapted brilliantly to what it was given — AND those same adaptations are now costing you something significant.
Both things are true. Neither cancels the other.
Jordan is a 42-year-old entrepreneur who grew up in a household with an emotionally volatile parent. She learned early that the safest way to navigate her home was to become exquisitely attuned to her parent’s emotional state — reading the room the moment she walked in, adjusting her behavior, her tone, her requests accordingly. She became, in other words, a survival expert. She learned to read people with extraordinary precision. She learned to anticipate conflict and defuse it before it erupted. She learned to perform calm when she felt terrified.
These skills made her a remarkably effective leader. She can read a room in seconds. She can defuse conflict before it escalates. She can project calm in crisis. Her team adores her. Her investors trust her. By every external metric, she is doing very, very well.
And she is exhausted in a way that sleep doesn’t fix. She has persistent anxiety she can’t quite source. She has a marriage that functions beautifully on the surface and feels lonely underneath. She can’t remember the last time she told someone she was struggling. She doesn’t know how to need things.
This is the Both/And. The same nervous system that protected her and helped her thrive is also the nervous system that can’t rest, can’t receive, can’t fully connect. Healing doesn’t mean condemning the adaptations — it means updating them. It means helping the nervous system understand that the original threat is no longer active, and that new strategies are available. This is the kind of work we do in trauma-informed therapy: not erasing the past, but creating more choices in the present.
The Both/And also applies to the body’s physical responses. The same cortisol surges that sharpened Camille’s thinking under deadline pressure are also disrupting her sleep. The same hypervigilance that makes Jordan a precise reader of people is also making it impossible for her to feel safe in her own home. The body is not the enemy. It’s working from an old map. The work is to draw a new one, together.
If you’re recognizing yourself in these descriptions and want to understand the relational dimension of what’s shaping your patterns, the complete guide to betrayal trauma explores how relational violations specifically affect the nervous system — and what recovery from that particular kind of wound looks like.
The Systemic Lens: When the Environment Itself Is the Stressor
Any honest conversation about trauma and the nervous system has to include a systemic lens — because the nervous system doesn’t develop in a vacuum. It develops in a body, in a family, in a culture, in a society. And some bodies, some families, some cultures, and some societies impose far higher chronic stress loads than others.
The research on allostatic load — the cumulative biological cost of chronic stress — makes this painfully clear. The nervous system of a woman who grew up in poverty carries a different calibration than the nervous system of a woman who grew up in safety and abundance. The nervous system of a woman who belongs to a marginalized racial or ethnic group that is regularly subjected to discrimination, microaggressions, and systemic exclusion carries a chronic activation load that has nothing to do with her individual psychology and everything to do with the environment she’s navigating.
This matters clinically for several reasons. First, it means that some of what presents as individual nervous system dysregulation is actually a rational, appropriate response to a genuinely threatening environment. The hypervigilance of a Black woman navigating a predominantly white professional space is not a trauma response in the pathological sense — it’s an accurate read of a system that is, in fact, less safe for her than for her white colleagues. Treating this as purely an internal problem to be fixed is both clinically inaccurate and ethically wrong.
Second, it means that healing is not solely an individual project. The nervous system heals in relationship, in community, in safety — and systemic change is part of creating the conditions for collective nervous system regulation. Research by Resmaa Menakem, MSW, LICSW, trauma therapist and author of My Grandmother’s Hands, has made a significant contribution here: his work on racialized trauma and the body argues that generations of systemic violence and oppression are encoded in bodies across generations, and that healing requires both individual somatic work and collective acknowledgment of historical harm.
Third, it means that when I work with driven, ambitious women — particularly those who belong to groups that have faced systemic barriers — I hold both dimensions simultaneously. What’s yours individually to heal, and what is the environment correctly asking your nervous system to track? Both can be true at once. And both deserve attention.
The Strong & Stable newsletter regularly addresses the intersection of systemic factors and individual nervous system healing — if you’re interested in this dimension of the work, it’s a good place to continue the conversation.
How the Nervous System Heals: Regulation Techniques and Therapies That Work
The nervous system heals differently than most people expect. It doesn’t heal through understanding alone — though understanding helps orient the work. It doesn’t heal through willpower. It heals through experience: repeated, embodied, safe experience of something different than what it learned to expect.
Here’s what the evidence supports, and what I’ve seen work consistently in my clinical practice:
Somatic Experiencing (SE), developed by Peter Levine, PhD, developer of Somatic Experiencing and author of Waking the Tiger: Healing Trauma, is a body-based approach that works with the nervous system’s own language. Rather than asking clients to narrate traumatic events, SE focuses on tracking body sensations, allowing the incomplete survival responses stored in the nervous system to complete their natural arc. The shaking that Camille experienced in the parking garage? That’s actually the nervous system doing something right — attempting to discharge stored survival energy. SE teaches clients to resource this process rather than suppress it.
EMDR (Eye Movement Desensitization and Reprocessing), developed by Francine Shapiro, PhD, psychologist and researcher who founded EMDR, uses bilateral stimulation — typically eye movements, taps, or tones — to help the brain reprocess traumatic memories so they lose their emotional charge. It’s one of the most researched trauma treatments available, with strong evidence across multiple clinical populations. What I’ve observed clinically: clients often describe EMDR as allowing a traumatic memory to “move” — to shift from something that felt present-tense and activating to something that feels genuinely past.
Polyvagal-informed therapy works explicitly with the nervous system’s three states, using techniques drawn from Stephen Porges’s research to help clients learn to recognize what state they’re in and to gently move toward regulation. This includes co-regulation with the therapist — the experience of being in the presence of another nervous system that’s regulated, which is itself healing — as well as somatic exercises that activate the ventral vagal system.
Nervous system regulation practices are things you can begin today, without a therapist in the room. These include:
Physiological sigh — a double inhale through the nose followed by a long exhale through the mouth, which research by Andrew Huberman, PhD, neuroscientist and professor at Stanford University, has identified as the fastest way to voluntarily down-regulate the sympathetic nervous system. This isn’t relaxation performance. It’s a specific physiological intervention.
Slow, extended exhale breathing — any breathing pattern in which the exhale is longer than the inhale activates the parasympathetic nervous system. Even three minutes of this can shift nervous system state meaningfully.
Grounding practices — orienting to the physical environment through all five senses, feeling the weight and contact of your body in space, making slow deliberate eye contact with physical objects. These activate the dorsal attention network and signal present-moment safety to the nervous system.
Co-regulation — being with another regulated nervous system. This is not a luxury. It is, according to Porges’s research, the primary mechanism through which human nervous systems have always regulated. Safe relationships aren’t just emotionally supportive — they are neurobiologically necessary for healing.
Movement and discharge — particularly trauma-sensitive yoga, dance, shaking practices, and other forms of movement that allow the body to complete interrupted survival responses. This doesn’t have to look therapeutic. It can look like a walk, a dance in your kitchen, a run.
A note about pacing: nervous system work is most effective when it’s titrated — introduced slowly, in small doses, with enough resourcing between sessions that the system doesn’t become re-traumatized. This is why working with a trained trauma therapist matters, particularly for more significant trauma histories. You can find out whether working one-on-one is the right next step at Annie’s Connect page.
What’s true across all of these approaches is that the nervous system heals relationally. It heals in safety. It heals through the gradual accumulation of experiences of being okay — not because someone said you should be, but because your body actually felt it. And that accumulation, over time, is what widens the window of tolerance, builds genuine resilience, and allows you to finally feel as steady inside as you’ve always appeared on the outside.
You didn’t choose the nervous system you developed. But you can participate in its healing — and that, in my experience, is one of the most meaningful things a person can do.
If you’re ready to do this work in community rather than alone, the Fixing the Foundations course offers nervous-system-informed tools and a pace-yourself structure designed specifically for driven women in recovery. And if you want to explore what individual support might look like, I’d encourage you to reach out to work with me directly.
FREQUENTLY ASKED QUESTIONS
Q: What’s the difference between stress and trauma? When does one become the other?
A: Stress is a nervous system response to a challenging situation that resolves once the situation passes — your system activates, handles the demand, and returns to baseline. Trauma is what happens when a stressor overwhelms the nervous system’s capacity to process and integrate it, leaving a residue that doesn’t fully clear. The distinction isn’t always about the severity of the event. It’s about whether the nervous system was able to complete its natural response cycle. A “minor” event can be traumatic if it happened at a particularly vulnerable developmental moment, if there was no one present to help regulate it, or if it triggered an older wound. And a genuinely severe event may be processed without lasting trauma if the person had adequate support, safety, and nervous system resources at the time.
Q: I function well at work. Can I really have trauma if I’m this high-functioning?
A: Yes — and this is one of the most common misconceptions I encounter. In my work with clients, functional capacity and nervous system dysregulation often coexist. Many driven, ambitious women have used professional achievement as a regulation strategy: staying busy enough, successful enough, producing enough that they don’t have to feel what’s underneath. The nervous system that learned to survive by excelling, by being indispensable, by never slowing down is not a healed nervous system — it’s a very effective one. The symptoms that show up tend to be less visible in professional settings and more visible in intimate relationships, in the body at night, or in moments of transition when the scaffolding of productivity temporarily collapses.
Q: How do I know if I’m in hyperarousal or hypoarousal — and does it matter which one I’m in?
A: It matters enormously, because the interventions that help are different for each state. Hyperarousal looks like anxiety, racing thoughts, emotional flooding, hypervigilance, tension, trouble sleeping, feeling “too much.” Hypoarousal looks like numbness, disconnection, fatigue that doesn’t lift, emotional flatness, difficulty concentrating, feeling “too little.” If you’re in hyperarousal, regulating down is the goal — longer exhales, slower movement, grounding practices, orienting to present-moment safety. If you’re in hypoarousal, the goal is gentle activation — movement, rhythm, warmth, engagement with another person. Applying an activating intervention when you’re already hyperaroused (like vigorous exercise when you’re panicking) can make things worse. Learning to identify your nervous system state is one of the most practical skills in trauma recovery.
Q: Can nervous system dysregulation be healed, or is this just how I’m wired now?
A: The nervous system is neuroplastic — meaning it can and does change throughout life in response to experience. This is not wishful thinking; it’s established neuroscience. What trauma wires, healing can rewire — though not through willpower, and not quickly. What the research and clinical evidence support is this: with the right interventions (somatic approaches, EMDR, polyvagal-informed therapy), adequate safety, and enough repetition, the nervous system’s baseline calibration can shift. The window of tolerance can widen. Hypervigilance can decrease. The capacity for rest, connection, and genuine ease can develop — sometimes for the first time. You weren’t born dysregulated. You adapted to circumstances. And adaptation in one direction means adaptation in another direction is possible.
Q: What’s the role of relationships in nervous system healing? I’ve been trying to do this work alone.
A: The nervous system, according to Polyvagal Theory, is fundamentally relational. It evolved to co-regulate with other nervous systems — not to regulate in isolation. Books, podcasts, and self-directed practices are genuinely valuable, and they have real limits. The experience of being in the presence of another regulated nervous system — a therapist, a trustworthy partner, a safe community — is itself a healing intervention that can’t be fully replicated solo. If you’ve been doing the intellectual work of trauma for a long time and not feeling the embodied shift, this is often why. The missing ingredient isn’t more information. It’s the experience of felt safety in relationship. This is why so much of what heals in therapy isn’t the technique — it’s the relationship itself.
Q: What’s the fawn response, and how do I know if I’m doing it?
A: Fawn is the survival response that looks like people-pleasing, appeasement, and self-erasure. It developed because, for some people in some environments, the most effective way to stay safe was to manage the emotional states of the people around them — to become what others needed, to minimize themselves, to avoid triggering anger or withdrawal by being preemptively compliant. Signs you might be fawning: you automatically agree with people even when you don’t, you feel anxious when someone is displeased with you and work urgently to repair it, you have difficulty identifying your own preferences and needs, you feel responsible for other people’s emotions, and you often feel resentful — a common signal that you’ve been abandoning your own needs to manage someone else’s. Fawn can look like warmth, generosity, and flexibility from the outside. Inside, it often feels like chronic exhaustion and a persistent, low-grade sense of not being quite real.
RELATED READING
van der Kolk, Bessel. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking, 2014.
Porges, Stephen W. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. Norton, 2011.
Levine, Peter A. Waking the Tiger: Healing Trauma. North Atlantic Books, 1997.
Siegel, Daniel J. The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. Guilford Press, 2012.
Walker, Pete. Complex PTSD: From Surviving to Thriving. Azure Coyote, 2013.
Menakem, Resmaa. My Grandmother’s Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies. Central Recovery Press, 2017.
WAYS TO WORK WITH ANNIE
Individual Therapy
Trauma-informed therapy for driven women healing relational trauma. Licensed in 14 states.
Helping ambitious women finally feel as good as their résumé looks.
Annie Wright is a licensed psychotherapist (LMFT #95719) and trauma-informed executive coach with over 15,000 clinical hours. She works with driven, ambitious women -- including Silicon Valley leaders, physicians, and entrepreneurs -- in repairing the psychological foundations beneath their impressive lives. Annie is the founder and former CEO of Evergreen Counseling, a multimillion-dollar trauma-informed therapy center she built, scaled, and successfully exited. A regular contributor to Psychology Today, her expert commentary has appeared in Forbes, Business Insider, Inc., NBC, and The Information. She is currently writing her first book with W.W. Norton.
Annie Wright is a licensed psychotherapist and relational trauma recovery specialist with over 15,000 clinical hours.
She helps ambitious women whose impressive lives don’t feel as good as they look—women who have used success as a shield but still struggle internally with anxiety, burnout, or relational pain. As the founder of a thriving therapy center she built, scaled, and sold, Annie now coaches and consults with women leaders, entrepreneurs, and professionals navigating identity shifts, leadership transitions, and the long arc of trauma recovery.
Her work has been featured in NPR, Forbes, Business Insider, and other national outlets. Annie blends deep clinical expertise with lived experience to help women build lives that are not only high-functioning, but deeply fulfilling.
What's Running Your Life?
The invisible patterns you can’t outwork…
Your LinkedIn profile tells one story. Your 3 AM thoughts tell another. If vacation makes you anxious, if praise feels hollow, if you’re planning your next move before finishing the current one—you’re not alone. And you’re *not* broken.
This quiz reveals the invisible patterns from childhood that keep you running. Why enough is never enough. Why success doesn’t equal satisfaction. Why rest feels like risk.
Five minutes to understand what’s really underneath that exhausting, constant drive.
