Trauma, anxiety, and relationships are intimately linked, often in a complex and multidirectional way. Relationships can cause trauma, leading to mental health struggles and anxiety. Meanwhile, anxiety can impact relationships, even leading to trauma. Conversely, traumatic experiences can cause anxiety, adding particular challenges to relationships.
Navigating the interplay between trauma, anxiety, and relationships can be incredibly challenging. Understanding how each affects the others, in addition to risk factors for specific difficulties, can help individuals or couples find coping strategies for dealing with the challenges of trauma and anxiety in relationships.
Trauma and Anxiety
The symptoms of a social anxiety disorder include intense fear of embarrassment or humiliation, low self-esteem, and discomfort in social situations. This generally leads to avoiding social situations, interfering with socialisation and relationship development, and sometimes contributing to loneliness and isolation. Social anxiety disorder is one of the most common mental disorders in the UK, with an estimated lifetime prevalence as high as 12%.[1] Social anxiety can be caused by various factors ranging from genetic predisposition to parenting style, childhood experiences, and brain functioning. Trauma exposure, particularly chronic or complex trauma, is thought to significantly affect the development of anxiety. Childhood trauma is associated with an increased risk of developing anxiety. Studies show a positive correlation between post-traumatic stress symptoms and anxiety, particularly in young adults.[2] This is a result of social, emotional, and neurobiological factors, although the specific impact of each is unknown.
Understanding Anxiety
To really understand the link between trauma and anxiety, it is helpful to know the effects that each has on the brain. Both anxiety and the fight-or-flight response, also called the stress response, trigger activity in the amygdala. The amygdala is the brain structure that detects stress and sends signals to other parts of the brain to respond with changes in heart rate and hormone release, in addition to a wide range of stress-related biological adaptations. The amygdala can detect both biological and emotional stressors. Biological stressors include injury or illness, while an emotional stressor is something in the environment that can cause fear, frustration, or sadness. This may include situations that present a genuine threat to life, such as a car accident or assault, as well as highly stressful situations in an objectively safe scenario, such as performing on stage or going on a date. Although the latter does not require the body to prepare for fighting off an ‘attack’, the highly-charged emotional response can inhibit the brain’s ability to communicate with the amygdala. It can also hinder the brain from aapplyinga normal level of reasoning to correctly identify the situation as either emotionally or physically safe.
Traumatic experiences and post-traumatic stress disorder (PTSD) worsen pre-existing social anxiety and contribute to the onset of the disorder. People predisposed to social anxiety, either genetically or as a result of parenting, often experience an intensification of symptoms following traumatic experiences. Additionally, people with social anxiety disorder are more likely to have experienced childhood emotional abuse and childhood emotional neglect than the general population. Moreover, childhood emotional abuse and neglect are linked to more severe symptoms of adult social anxiety.[3]
How Trauma Affects Anxiety
In adults and adolescents, trauma can cause people to internalise the event and experience invasive negative thoughts about themselves, which may include guilt, shame, and weakness. Individuals may also generalise the event, developing negative thoughts and beliefs about the world. The persistence of these thoughts can impact people’s ability to socialise and trust themselves, others, or the world generally.
Childhood trauma or compounded complex trauma can have a biological effect on the body and emotional processing. When the fight-or-flight response is persistently triggered, such as in sexual or domestic abuse, conflict, neglect, or war, it can cause an overactive stress response. People who experience childhood abuse often become hypervigilant, constantly scanning their environment and other people’s responses for danger.
Childhood trauma can also cause long-lasting changes to the brain structure and nervous system, including a larger or overactive amygdala. An enlarged or overactive amygdala is can cause an increased reaction to danger.
Navigating Relationships with Social Anxiety and Trauma
Being in a relationship with someone who experiences social anxiety or having social anxiety yourself can be challenging to navigate at times. If trauma or PTSD is present, it can further complicate or compound these difficulties.
Supporting a Partner With Trauma or Anxiety
It is common for people who have experienced trauma to behave in ways that may seem unreasonable or difficult for their partner to understand. For those with an overactive stress response or hypervigilant, a regular conversation or situation can escalate quickly to anger, fear, anxiety, uncertainty or mistrust. They may experience panic attacks or become disengaged as a result.
During these moments of heightened anxiety, it can be challenging for anxious or traumatised individuals to express their feelings and why something has triggered or upset them. In many stressful or anxiety-inducing situations, the cortex – the part of the brain responsible for emotional processing, problem-solving and communication – will have been affected, making it difficult for those who have experienced trauma to articulate what is really going on in their head. This can lead to further conflict and miscommunication, potentially making the situation worse, and it makes it difficult for well-meaning partners to know how to give support.
Recognising the signs that your partner has become anxious or triggered can help you respond more patiently and measuredly. Identifying particular triggers or anxiety-inducing situations can help both people in a relationship to create certain coping mechanisms and prepare adequately for the stressor. It may also be useful to support a partner in identifying their distress and knowing how to proceed. During an argument or conflict, if a person can identify, on a scale of 0-10, how distressed they are at that moment, it can help their partner choose the correct response, potentially taking a break from a conversation rather than continuing to engage.
Although anxiety can take a toll on relationships, sometimes making it difficult to form or maintain intimate partnerships, a healthy, fulfilling relationship is always possible. Finding support as an individual or a couple, identifying specific triggers, and maintaining open, genuine and non-judgemental communication can support coping skills, healing and mastery of an over-active amygdala.
If you have a client or know of someone struggling with anything you have read in this blog, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).
Sources:
[1]Overview: Social anxiety disorder: Recognition, assessment and treatment: Guidance. NICE. Retrieved March 20, 2023, from https://www.nice.org.uk/guidance/CG159
[2] Bruijnen, C. J. W. H., Young, S. Y., Marx, M., & Seedat, S. (2019). Social anxiety disorder and childhood trauma in the context of anxiety (behavioural inhibition), impulsivity (behavioural activation) and quality of life. The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa, 25, 1189. https://doi.org/10.4102/sajpsychiatry.v25i0.1189
[3] Kuo JR;Goldin PR;Werner K;Heimberg RG;Gross JJ; (n.d.). Childhood trauma and current psychological functioning in adults with social anxiety disorder. Journal of anxiety disorders. Retrieved March 20, 2023, from https://pubmed.ncbi.nlm.nih.gov/21183310/
