Anxiety and Trauma: When there is more to physical symptoms than meets the eye

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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 is also contributing to these symptoms? According to acupuncturist David Euler, this calls for a different approach, one in which the physical complaint does 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 the practitioner uses 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 may help people experiencing the effects of psychological trauma. Psychological trauma can develop when someone goes through an experience so overwhelming that it is difficult to process. It changes the way the brain, body and nervous system perceive safety. This can have a significant impact on everyday life.
The effects vary widely. They may include difficulty concentrating, forgetfulness, flashbacks, nightmares, anxiety and a constant state of alertness. Mood swings may also occur, putting strain on relationships and affecting a person's ability to function at work. Some people experience suicidal thoughts or turn to alcohol, drugs or risky behaviour.

Trauma can also be associated with physical symptoms, such as sleep disturbances, headaches, muscle tension, digestive 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 in many different ways, including anxiety. When I know that someone has post-traumatic stress disorder (PTSD), I adapt my assessment and treatment accordingly. I use an examination technique 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 first on addressing the effects of trauma before treating other complaints.
This approach is based on ancient texts of Chinese medicine, 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 sessions. This is not unusual. In these situations, I take extra time to explain what they can expect during treatment. I also provide soothing background music. I usually use specific sound frequencies known as 40-hertz binaural beats, which are intended to stimulate certain types of brain activity and improve concentration. If someone would like a glass of water, I offer that as well.
Sometimes I deliberately keep the first session 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 to have sufficient knowledge of mental health conditions and how to respond to them appropriately. At the same time, you must recognise the limits of your own expertise. Sometimes it is better to postpone acupuncture treatment because a person first needs psychiatric care.

What would you like people to better understand about the effects of anxiety and long-term stress?

David: Good patient education is often an important factor in successful treatment. Many people do not fully realise how prolonged stress and anxiety can affect their bodies.
In my view, chronic stress and anxiety can lead to adrenal exhaustion, long-term cardiovascular problems and disturbances in the autonomic nervous system. This is the part of the nervous system that regulates functions such as heart rate, breathing and digestion.

Inflammatory processes may 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 can affect not only how they feel, but also their physical health.

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