How Childhood Trauma Affects Your Nervous System as an Adult

TRAUMA RECOVERY • July 23, 2026

1. When Your Body Won’t Let You Rest

Casey is 42, sitting on the edge of her bed at 11:40 on a Tuesday night, still in her blazer because taking it off felt like too many steps. The house is quiet. Her kids are asleep. Her husband is asleep. The dishwasher is running its last cycle, that low mechanical hum she’s come to find almost soothing. She has done everything on her list. She closed the Fenwick account today, the one she’d been sweating over for three weeks, and closed it well. And she is lying here with her heart going like she’s still in the room, still watching the client’s face for the flicker that tells her whether the deal is holding.

“I don’t understand what’s wrong with me,” she told me the following week, turning her water bottle in slow circles on her knee, the label half peeled off from a habit she wasn’t aware she had. “The meeting went well. I got what I wanted. And I came home and I could not turn off. I lay there for an hour just… scanning. Waiting for something. I don’t even know what I was waiting for.”

In my work with clients like Casey, I see this exact confusion constantly: a nervous system stuck in high alert long after the actual danger, if there ever was danger in the room at all, has passed. It isn’t a character flaw and it isn’t a sign that she’s ungrateful for a life that, from the outside, looks entirely enviable. Something in her body learned a long time ago that vigilance was the price of safety, and that lesson doesn’t check a calendar to see whether it’s still 2026 and whether the person across the table is a client or a parent.

This is what childhood trauma does to the nervous system. Not a wound that sits quietly in the past. A live, ongoing calibration that keeps running in the present, in your body, on a Tuesday night when the dishwasher hums and everyone else in the house is asleep.

2. What Is Childhood Trauma, Really?

Before we can talk about what childhood trauma does to the nervous system, we need a working definition, because the word gets used so loosely that it’s lost some of its clinical precision.

I recently read Judith Herman, MD, the psychiatrist whose 1992 book Trauma and Recovery reshaped how the field talks about prolonged, repeated trauma, and I keep returning to one distinction she draws: a single terrifying event asks something different of a nervous system than years of low-grade, unpredictable threat. In a later piece responding to debate in the field, Herman argued that the cumulative, developmental form of trauma produces a clinical picture distinct enough that it deserves its own diagnostic category, separate from single-incident PTSD (Herman, 2012). Whether or not you find the diagnostic argument compelling, the clinical picture she’s describing is one I recognize daily: it’s rarely the single event that brings a driven, accomplished woman into my office. It’s the slow accumulation.

Casey, when I first described this distinction to her, the difference between a single overwhelming event and years of low-grade unpredictability, said her childhood didn’t have a headline moment she could point to. “Nothing happened,” she said, and then caught herself. “I mean, plenty happened. Just nothing you’d put in a movie.” That’s Complex Trauma in one sentence, in my experience: rarely a single scene, almost always a thousand ordinary Tuesdays.

The Adverse Childhood Experiences (ACEs) research gives us a sense of scale here. Vincent Felitti, MD, and Robert Anda, MD, led the original 1998 Kaiser-CDC study that first linked categories of childhood adversity, things like household substance use, emotional neglect, and witnessing domestic violence, to adult health outcomes decades later, finding a graded relationship: more categories of adversity in childhood predicted higher rates of adult depression, substance use, and chronic disease (Felitti et al., 1998). A more recent nationally representative analysis using the 2016 National Survey of Children’s Health estimated that a substantial share of U.S. children experience at least one recognized adverse childhood experience before age eighteen (Bethell et al., 2019). Childhood trauma, in other words, is common. Not rare, not fringe, not something that only happens in the households we picture when we hear the word “abuse.”

3. The Nervous System’s Threat-Detection Job

Here’s what I want you to understand before anything else: your autonomic nervous system has one job, and it is not comfort. It’s survival. It’s constantly, silently asking a question beneath your conscious awareness: is this safe, or is this a threat? And it’s answering that question based largely on pattern-matching against everything that happened to you before you had language to argue with it.

I want to be careful here about a claim you’ll see everywhere in popular trauma writing, including, I’ll admit, in some of my own earlier posts on this site: the idea that “trauma is stored in the body,” full stop, as though the body were a warehouse and the memory a fixed object sitting on a shelf. That framing is popular because it’s vivid, but it flattens something more precise and, I think, more useful. What the research actually supports is that early relational experience calibrates how your threat-detection system responds, how quickly it activates, how intensely, and how long it takes to stand back down. Bessel van der Kolk, MD, the psychiatrist and trauma researcher, argued in a widely cited 1994 review that traumatic memory may be organized and experienced differently from ordinary narrative memory, carrying a strong sensory and affective charge rather than a clean, chronological storyline (van der Kolk, 1994). That’s a conceptual account drawn from clinical observation, not a definitive, settled proof of a simple storage model, and I want to represent it that way rather than overstate what one review paper can establish. The distinction I’m drawing matters because the warehouse framing can feel like a life sentence. The calibration framing is closer to what I actually see change in session, over time, with the right work.

It’s also worth naming that Polyvagal Theory, Porges’s framework and probably the single most cited nervous-system model in the popular trauma literature, is still an active, evolving area of research rather than settled neuroscience. Porges himself has continued revising and defending specific mechanisms of the theory against critique well into the 2020s (Porges, 2025). I find the model clinically useful, as a map for talking with clients about states of activation and shutdown. I don’t present it to clients as proven fact, and I won’t present it that way here either.

Casey asked me, early on, whether there was a name for what was happening in her nervous system, something more precise than “anxious.” I told her what I’ll tell you: there’s a name for the pattern, threat-system calibration shaped by chronic early unpredictability, but there isn’t a single clean diagnosis that captures the whole of it, and I’d be misleading her if I handed her one just to make the conversation feel tidier. She sat with that for a minute, turning her water bottle. “I think I wanted you to just tell me the name of the thing,” she said. “So I could go look it up and fix it.” That impulse, the desire for a diagnosis she could research her way out of, is itself part of the pattern we were there to understand.

4. How a Calibrated Nervous System Shows Up in Driven Women

What therapists call sympathetic activation, the “fight-or-flight” branch of your nervous system flooding your body with cortisol and adrenaline, most clients experience first as something much less clinical: a racing heart before a Slack notification even loads, jaw clenched through a client call that’s actually going fine, the specific dread of an unread email from a boss whose tone you can’t yet read. Which means in practice that a woman can be objectively excellent at her job, closing accounts, running teams, raising children, and still spend her Tuesday nights unable to figure out why her body won’t let her rest.

Casey, three weeks into our work together, put it better than I could have. “I used to think I was just a Type A person,” she said, feet tucked under her on my office couch, the November light going gray outside the window. “Like, this is just who I am, I’m intense, I get things done. But then I started noticing that the intensity doesn’t turn off even when there’s nothing left to do. I finished the project. There’s no fire. And I’m still standing in my kitchen at nine at night reorganizing the pantry because sitting down feels unbearable.”

What I’ve come to think of as the achievement-as-armor pattern shows up in almost every driven woman I’ve worked with who grew up in an unpredictable household. If you learned early that being useful, being flawless, being the one who noticed the mood shift before anyone else did, kept you safer, then your nervous system built its entire operating strategy around vigilance and performance. That strategy worked. It’s part of why she made partner, why she runs the team, why she can read a room before she’s finished walking into it. The problem isn’t that the strategy failed. The problem is that it never got the memo that the danger it was built for isn’t in this room anymore.

Casey’s spreadsheet brain, the same instinct that let her track nine variables on the Fenwick deal without breaking a sweat, is the identical mechanism that keeps her awake calculating whether her tone in a text to her sister sounded “off.” Both are her threat-detection system doing exactly what it was trained to do. One just happens to be professionally rewarded and the other keeps her up until midnight.

There’s a clinical name for the specific flavor of this that Casey lives with, and it’s worth naming precisely because the word gets used loosely online.

Six weeks into our work, Casey brought this back to me in a way that stuck. It was a Thursday, and she’d just come from her daughter’s school pickup line, sitting in her car with the engine still running. “I watched myself do it today,” she said. “My daughter’s teacher waved me over, just to say something totally normal about the field trip form, and my whole body braced like I was about to be told something was wrong. She hadn’t even opened her mouth yet. I was already bracing.” That bracing, before any actual information has arrived, is hypervigilance doing its job a half second too early and a few decades too late.

5. The Freeze Response Nobody Talks About

Most popular writing about trauma responses stops at fight-or-flight, but there’s a third response that shows up constantly in my clinical work and gets almost no airtime: freeze, sometimes called shutdown, the parasympathetic branch’s other mode. Porges’s model describes this as a dorsal vagal response, distinct from the calm, restful parasympathetic state, that essentially takes the body offline when fight or flight aren’t viable options (Porges, 1995).

Brenda is 44, an operations director at a logistics company, and she came to see me describing something she called “going gray.” “It’s not that I panic,” she told me, sitting very still in the chair, her coat still zipped even though my office is warm. “It’s the opposite. In the meeting where my director basically implied my project was a mess in front of everyone, I didn’t feel anything. I just went flat. I answered his questions in this completely calm voice and then I drove home and I don’t actually remember the drive. I don’t remember twenty minutes of my own life.”

Sitting with Brenda that day, I felt the particular stillness that tells me a client is describing dissociation rather than composure. It can look, from the outside, like remarkable poise under pressure. From the inside, it’s the nervous system pulling the plug because full activation, the fight or the flight, wasn’t available to her, not as a child in a house where fighting back got her hit harder, and not now, as an operations director in a room full of people she reports to.

“I used to think I was just really good in a crisis,” Brenda said, turning the zipper pull on her coat back and forth. “Now I’m wondering if I’m not calm. I’m just gone.”

The freeze response deserves the same respect we give fight-or-flight: it was adaptive once. It kept a child safe when fighting or fleeing would have made things worse. The trouble is what happens when the nervous system generalizes that same shutdown to every subsequent room that feels even faintly similar, a critical boss, a raised voice, a tone she can’t quite place, and the shutdown fires whether or not shutdown is actually the safest response to a boardroom disagreement in 2026.

6. Both/And: You Can Be Capable and Still Be Dysregulated

Here is the both/and I want to name directly, because I think it’s the single hardest thing for driven, accomplished women to hold: you can be extraordinarily capable, excellent at what you do, trusted by your team, respected by your clients, and still be running on a dysregulated nervous system. These aren’t contradictions. They can be, and often are, the exact same adaptation wearing two different outfits.

Casey said something in our fourth session that I still think about. “I keep waiting for someone to tell me which one is true. Am I actually good at my job, or am I just anxious and it looks like competence from the outside?” I told her what I’ll tell you here: it’s not either/or. The vigilance that makes her excellent at anticipating a client’s objections before they voice them is drawing from the same well as the vigilance that keeps her awake scanning for danger that isn’t there. You don’t get to keep the professional upside and surgically remove the 11:40pm cost. It’s one system. The work isn’t choosing between the capable version of you and the exhausted version of you. It’s helping the same nervous system learn that it has more than one gear.

This both/and framing matters clinically because the alternative, treating dysregulation as evidence that something is fundamentally broken in you, tends to backfire. Shame doesn’t calm a nervous system. It activates it further, adding a layer of self-monitoring on top of the environmental monitoring that’s already running. Of course you’re tired. You’ve been doing two jobs at once for years, the actual job and the internal job of managing a threat-detection system that never quite learned the danger passed. I watched Casey’s shoulders drop half an inch the first time I said this to her plainly, without qualification.

I want to be precise about what “dysregulated” means and doesn’t mean here, because the word gets thrown around loosely in wellness spaces until it loses meaning. A dysregulated nervous system isn’t a damaged one, and it isn’t a permanent diagnosis. It describes a system whose threshold for activation, and whose ability to return to baseline afterward, has been shaped by chronic unpredictability. That’s a description of calibration, not a verdict on your character or a life sentence on your capacity to change.

7. The Systemic Lens: Why This Isn’t a Personal Failing

It would be incomplete, and honestly a little dishonest, to talk about nervous system dysregulation purely as an individual, private matter that lives inside a single household. The proverbial house of life, the family system a child grows up in, doesn’t build itself in a vacuum. It’s built on ground that’s already uneven.

Economic precarity produces chronically stressed, financially anxious parents who have less capacity for the kind of consistent, attuned presence that helps a child’s nervous system learn safety. Systemic racism means Black and Hispanic children in the United States are documented at higher rates of adverse childhood experiences than white children in the same national surveys, not because of anything inherent to those families, but because of generations of structural exposure to housing instability, over-policing, and economic exclusion (Bethell et al., 2019). The attention economy, the always-on culture of email and Slack that most of my clients are professionally rewarded for participating in, actively works against nervous system recovery by keeping the sympathetic branch perpetually half-engaged, a notification away from activation, every single day of adult life.

None of this erases what happened inside any one household. A parent’s unpredictability, a parent’s rage, a parent’s absence, still lands specifically and personally on the child living inside that home. But the ground those households sat on wasn’t level, and pretending otherwise puts the entire burden of repair on individuals who were never the ones who tilted the terrain in the first place.

Casey grew up the oldest of three in a household where her father’s job losses arrived every eighteen months or so, like clockwork, in a regional economy that kept contracting through her entire childhood. Her hypervigilance wasn’t only about her father’s temper, though that was real too. It was also about a nervous system that learned, correctly, that the ground under the family could actually shift without warning, because it kept doing exactly that. Naming the economic instability doesn’t erase what her father did with his fear. It explains part of where his fear came from, and it means the work of healing Casey’s nervous system was never going to be purely a private, individual matter, separate from the recession that shaped her childhood zip code.

What this looks like in practice, for a client like Casey, is a life where the structural pressure never really lets up long enough for the nervous system to recalibrate. She isn’t only managing childhood-origin hypervigilance. She’s managing it inside a career culture that rewards the exact symptoms of dysregulation, the extra hours, the instant responsiveness, the inability to fully switch off, as evidence of dedication. Healing a nervous system shaped by an unpredictable childhood is hard enough on its own. Healing it while your adult environment keeps offering the same nervous system a reason to stay activated is a different order of difficult, and it isn’t a personal failing that it takes longer than a weekend retreat.

8. How to Begin Working With Your Nervous System

I’m not going to give you a five-step protocol here, and that’s a deliberate choice, not an oversight. Nervous system work is not a script you follow alone at your kitchen table, and I’d be doing you a disservice, and stepping outside what’s responsible for me to offer in a blog post, if I implied otherwise. What I can offer is a more honest map of what the actual work tends to involve, so you know what you’re looking for.

Most of the clients I see doing sustained nervous system work over time are engaged in some combination of body-based or somatic therapy approaches, ongoing work with a trauma-informed clinician who can help distinguish between old threat-responses and present-tense reality, and, often, EMDR (Eye Movement Desensitization and Reprocessing), which I’ve written about at length elsewhere on this site if you want the fuller picture of what EMDR actually feels like in session. What all of these approaches have in common is that they work with the nervous system directly rather than only with insight and narrative. Understanding intellectually why you’re hypervigilant, useful as that understanding is, doesn’t always change the activation pattern on its own. Casey knew, cognitively, within our second session, exactly why she couldn’t sleep after a good day at work. Knowing didn’t make the 11:40pm scanning stop. The somatic work, over months, is what started to.

Co-regulation, the process by which one nervous system helps another find safety, matters enormously here too, and I’ve written a fuller explanation of how co-regulation works between adults, because a lot of the repair that couldn’t happen with an unpredictable parent in childhood can, with the right people, happen now. This is also part of why the therapeutic relationship itself carries real weight in the mechanism of change. It isn’t only a container for delivering techniques.

If any of this sounds like the gap between how capable you look and how exhausted you feel, described elsewhere on this site as the pattern of never feeling like enough no matter what you accomplish, it may be worth reading further into how that plays out specifically at work, including the difference between fawning at work and actually being a strong team player, or into what it means to have effectively raised yourself while your parents were physically present.

Casey is still, as I write this, in the middle of her work. I don’t have a tidy resolution for you, because there isn’t one yet. What I can tell you is that six months in, she texted me a photo of her water bottle, the label finally, fully peeled off in one clean piece instead of the anxious shredding I’d watched her do in session after session, with no caption at all. I don’t know exactly what that meant to her. I know it meant something. Some Tuesday nights she still can’t turn off. Fewer of them than before.

If any part of this resonates and you’re wondering whether it’s worth exploring further, you might start with this brief relational trauma quiz, which is designed to help you get a clearer, more specific picture of your own patterns before you decide what kind of support makes sense next.

Frequently Asked Questions

Related Reading

• Herman, Judith. Trauma and Recovery: The Aftermath of Violence, from Domestic Abuse to Political Terror. New York: Basic Books, 1992.
• van der Kolk, Bessel. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking, 2014.
• Porges, Stephen W. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. New York: W.W. Norton, 2011.
• Sacks, Vanessa, and David Murphey. “The Prevalence of Adverse Childhood Experiences, Nationally, by State, and by Race or Ethnicity.” Child Trends Research Brief, February 2018.

References

1. Cloitre M, Stolbach BC, Herman JL, van der Kolk B, Pynoos R, Wang J, Petkova E. A developmental approach to complex PTSD: childhood and adult cumulative trauma as predictors of symptom complexity. J Trauma Stress. 2009;22(5):399-408. doi:10.1002/jts.20444. PMID: 19795402.
2. Herman JL. CPTSD is a distinct entity: comment on Resick et al. (2012). J Trauma Stress. 2012;25(3):256-257. doi:10.1002/jts.21697. PMID: 22729977.
3. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245-258. doi:10.1016/S0749-3797(98)00017-8. PMID: 9635069.
4. Bethell C, Jones J, Gombojav N, Linkenbach J, Sege R. Adverse childhood experiences, resilience and mindfulness-based approaches: common denominator issues for children with emotional, mental, or behavioral problems. Child Adolesc Psychiatr Clin N Am. 2019. PMID: 31003066.
5. Porges SW. Orienting in a defensive world: mammalian modifications of our evolutionary heritage. A polyvagal theory. Psychophysiology. 1995;32(4):301-318. PMID: 7652107.
6. Porges SW. Polyvagal Theory: current status, clinical applications, and future directions. Clin Neuropsychiatry. 2025. PMID: 40735382.
7. van der Kolk BA. The body keeps the score: memory and the evolving psychobiology of posttraumatic stress. Harv Rev Psychiatry. 1994;1(5):253-265. doi:10.3109/10673229409017088. PMID: 9384857.

Warmly, Annie

About the Author

Annie Wright, LMFT

LMFT · Relational Trauma Specialist · W.W. Norton Author

Helping driven 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 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.

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