Fear and trauma: when there is more at play than just physical complaints – a conversation with David Euler

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‘Trauma changes the way the brain, body and nervous system experience safety.’

You seek treatment for headaches, sleep problems or persistent tension. But what if anxiety or a distressing experience lies behind these symptoms? According to acupuncturist David Euler, this calls for a different approach, one in which the physical symptoms do not always take priority.
David Euler is an internationally renowned lecturer with decades of experience as an acupuncturist. He specialises in palpation-based acupuncture, an approach in which practitioners use touch to gather information about the body. He was also involved in acupuncture education at Harvard Medical School for many years.

During Acupuncture Awareness Week, he will present a webinar for NVA-members on anxiety and trauma. We asked him how distressing experiences can affect the body and what this means for his approach to treatment.

How can a distressing experience affect someone?
David: The word trauma comes from Greek and literally means ‘wound’. We distinguish between physical and psychological trauma. My main focus is on how acupuncture can help with the effects of psychological trauma.

Psychological trauma can occur when someone goes through an experience so overwhelming that it is difficult to process. It changes the way the brain, body and nervous system experience safety. This can have a significant impact on everyday life.
The effects can vary widely. They may include difficulty concentrating, forgetfulness, flashbacks, nightmares, anxiety and a constant state of heightened alertness. Mood swings can also occur, putting strain on relationships and affecting a person's ability to function at work. In some cases, people may experience suicidal thoughts or turn to alcohol, drugs or risky behaviour.

Trauma can also cause physical symptoms, such as sleep problems, headaches, muscle tension, gastrointestinal problems and an increased heart rate. Elevated cortisol levels may also contribute to higher blood sugar and cholesterol levels.

What does this mean for the way you treat someone?
David: Psychological trauma can manifest itself in many different ways, including anxiety. When I know that someone has post-traumatic stress disorder (PTSD), I adapt my examination and treatment accordingly.
I use an examination method in which I feel specific areas of the body with my hands to gather information. This is known as palpation-based assessment. When someone is experiencing the effects of trauma, I take this into account during the examination and adjust my treatment strategy. I focus on the effects of trauma first, before treating other symptoms.
This approach is based on centuries-old Chinese medical texts, including the Su Wen and the Ling Shu.

How do you approach someone who feels anxious or uncomfortable during treatment?
David: People with PTSD may feel vulnerable, uncomfortable or anxious during their first acupuncture treatments. This is not unusual. In these situations, I take extra time to explain what they can expect during treatment. I also provide pleasant background music. I usually use special sound frequencies, known as 40 Hz binaural beats, which are intended to stimulate certain types of brain activity and concentration. If someone would like a glass of water, I offer them one as well.

Sometimes I deliberately keep the first treatment short and focus primarily on the emotional aspects of their symptoms.

What does this require of you as an acupuncturist?
David: As an acupuncturist, you work from a holistic perspective, looking at the person as a whole. This means you also need sufficient knowledge of mental health problems and how to deal with them. At the same time, you need to recognise your own limitations. Sometimes it is better not to treat someone with acupuncture just yet, because they first need psychiatric care.

What would you like people to understand better about the effects of anxiety and prolonged stress?
David: Providing clear information is often important for successful treatment. Many people do not fully realise the effects that prolonged stress and anxiety can have on their bodies.
In my view, chronic stress and anxiety can lead to adrenal exhaustion, long-term cardiovascular problems and disturbances of the autonomic nervous system. This is the part of the nervous system that regulates functions such as heart rate, breathing and digestion.
Inflammatory processes can also develop, potentially contributing to autoimmune diseases and conditions such as diabetes, arthritis and cancer.

That is why I believe it is important for people to understand that prolonged stress and anxiety affect not only how they feel, but also their physical health.

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