Healing Trauma: Understanding the Brain, Body, and Nervous System

What is Trauma?

Trauma occurs when an individual experiences overwhelming or distressing events that exceed the body’s and mind’s ability to process and cope. Trauma can be caused by a single event or ongoing stressors, and it significantly impacts both psychological and physiological functioning.

Our brains are wired for survival. When a threat is perceived, the Sympathetic Nervous System (SNS) activates, preparing the body for action—either by fighting, fleeing, or freezing. The Autonomic Nervous System (ANS) regulates these survival responses, working to maintain the body’s internal balance, or homeostasis. The Parasympathetic Nervous System (PNS) helps restore calm by counteracting the SNS, bringing the body back to a "rest and digest" state once the danger has passed.

However, prolonged trauma can disrupt this balance, impairing the nervous system’s ability to regulate itself. Chronic activation of the SNS leads to hyperarousal, which is often experienced as persistent anxiety, insomnia, irritability, and a constant sense of being "on edge." Meanwhile, lack of PNS activation due to ongoing stress can result in hypoarousal, which manifests as emotional numbness, dissociation, or feeling "frozen" and detached from reality.

Common Trauma Responses: Fight, Flight, and Freeze

Fight Response:

The fight response is triggered by the SNS in response to perceived danger, preparing the body to confront or defend against a threat. Emotionally, this response manifests as anger, frustration, or defensiveness. Physically, it may cause muscle tension, increased heart rate and blood pressure, rapid breathing, and restlessness. Behavioral manifestations of this response include aggression, over-control, and avoidance of vulnerability.

Flight Response:

The flight response, also triggered by the SNS, prepares the body to escape a threat. Emotionally, it can lead to anxiety, panic, avoidance of negative emotions, or a feeling of being overwhelmed. Physically, the flight response often results in shallow breathing, hyperventilation, chest tightness, and fatigue. Behaviors linked to this response include withdrawal, avoidance, overworking, distraction, and denial.

Freeze Response:

The freeze response, activated by the dorsal vagal branch of the PNS, occurs when a threat feels insurmountable or unavoidable. This survival mechanism leads to emotional numbness, helplessness, and dissociation. Physically, it manifests as immobilization, muscle tension, and fatigue. Behaviors related to this response include inertia, social withdrawal, disconnection from reality, and shutdown.

Trauma and Memory

Trauma impacts critical brain areas like the hippocampus, which is responsible for memory formation and distinguishing between past and present experiences. When the hippocampus is dysregulated by trauma, memories may not be properly stored or contextualized, resulting in fragmented, vivid, and intrusive recollections. Traumatic memories can resurface in the present moment without the proper context of time, leading to flashbacks and emotional overwhelm.

Trauma and Hormones

Trauma can have a profound effect on the body’s regulation of stress hormones, particularly cortisol and adrenaline. Adrenaline, or epinephrine, is the body’s primary "fight-or-flight" hormone, preparing it for immediate action. Chronic trauma can lead to persistently elevated adrenaline levels, keeping the body in a state of hypervigilance, which contributes to anxiety and heightened stress.

Cortisol, known as the "stress hormone," plays a key role in the body's stress response by suppressing non-essential functions. Prolonged trauma can cause elevated cortisol levels, which can impair immune function, increase inflammation, and lead to chronic fatigue, anxiety, and mood disturbances. Proper management of cortisol through trauma therapy and lifestyle changes can help restore balance in the body’s stress response system.

Healing Trauma: Targeting the Brain and Body

The good news is that trauma is not permanent. Neuroplasticity—the brain’s ability to reorganize and adapt—offers a path to healing. Trauma-focused therapies such as EMDR, Cognitive Behavioral Therapy (CBT), somatic experiencing, and mindfulness techniques work to rewire the brain and restore balance to the nervous system. These approaches promote emotional regulation and help integrate traumatic memories in a way that minimizes their disruptive impact on daily life. If you’re struggling with the effects of trauma, healing trauma through therapy can be transformative. Not only does trauma therapy help manage symptoms like anxiety, insomnia, and dissociation, but it also targets the root causes of trauma and the dysregulation of the nervous system, allowing for deeper healing.

Wishing you all the best on your healing journey,

Mental Health in France: Understanding and Navigating Cultural Differences

Mental health is shaped by cultural norms, societal expectations, and the structure of a country’s healthcare system. Even the way mental health conditions are diagnosed and treated can varry from one country to another. For expats in France, understanding how mental health care works can help avoid confusion, invalidation, and frustration. This article explores how France’s cultural attitudes toward mental health, both within society and its healthcare system, inform therapy and what expats can expect when seeking support.

France’s Cultural Perspective on Mental Health

Mental health care in France has long been influenced by psychoanalysis, particularly the work of Sigmund Freud and Jacques Lacan. This means many French therapists focus on exploring unconscious thoughts, childhood experiences, and deep-rooted conflicts. In contrast, therapy in the U.S. and other English-speaking countries often leans more toward practical, solution-focused approaches like Cognitive Behavioral Therapy (CBT). 

Mental health stigma also exists in some areas of French society, particularly in professional settings. While attitudes are changing, some people still hesitate to seek therapy due to concerns about judgment or privacy. However, younger generations are becoming more open to discussing mental health and seeking support.

Mental Health Care in France: Diagnosis and Accessibility

France uses the CIM-10 (International Classification of Diseases) from the World Health Organization, while many English-speaking countries rely on the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). These differences can impact diagnoses and treatment options.

Key Differences in Diagnosis:

• ADHD & Autism: Diagnosing neurodivergence in France can be more difficult due to stricter criteria and older psychoanalytic interpretations. While awareness is increasing, some doctors remain hesitant to adopt updated diagnostic standards.

• Dissociative Disorders: Conditions like Dissociative Identity Disorder (DID) are less widely recognized in France compared to the U.S. or U.K., making it harder to find specialists in this field.

• Personality Disorders: French clinicians often use psychodynamic theories rather than DSM-5 classifications, which can lead to different diagnostic terms and treatment approaches.

Accessing Therapy in France

Finding the right therapist in France can be challenging for expats due to language barriers, different therapy styles, and how the healthcare system works.

Key Considerations:

• Psychoanalysis vs. CBT: Traditional psychoanalysis is still common, but evidence-based therapies like CBT are becoming more popular, especially among younger therapists and international practitioners.

• Healthcare Coverage: France’s national healthcare system (Sécurité Sociale) partially covers psychiatric care and some therapy services when provided by a psychiatrist. However, sessions with psychologists or psychoanalysts usually require out-of-pocket payment. Expats with international insurance should check for reimbursement options.

• Finding an English-Speaking Therapist: Many expatriates prefer therapy in their native language. Fortunately, Paris has a growing network of bilingual therapists who understand the challenges of adjusting to life in a new country.

Alternative and Holistic Healing Practices in France

Beyond traditional therapy, France has a strong tradition of holistic and complementary healing methods. I integrate some of these approaches into my clinical work, particularly somatic and mindfulness-based therapies, which are supported by research in trauma recovery. Some commonly used practices include:

• Herbal Medicine & Homeopathy: Natural remedies are widely accepted and available in most pharmacies.

• Somatic & Body-Based Therapies: Yoga, sophrology, and osteopathy are often used for stress relief and trauma recovery.

• Mindfulness & Meditation: While not as mainstream as in some other cultures, mindfulness is becoming more recognized and is increasingly incorporated into therapy.

Navigating Mental Health Care as an Expat in France

If you're an expatriate looking for mental health support in France, it's important to:

1. Understand Diagnostic Differences: Some conditions may be diagnosed differently. Seek professionals familiar with both CIM-10 and DSM-5 for a more comprehensive assessment.

2. Find a Therapist Who Understands Expats: English-speaking therapists with experience working with expatriates can provide culturally sensitive care.

3. Check Insurance & Reimbursement Options: Some international health insurance plans cover therapy, and certain professionals may offer services that qualify for partial reimbursement.

Final Thoughts

Understanding how mental health care works in France can help expats find the right support and make informed choices. Whether you're looking for traditional psychotherapy, a diagnosis, or holistic treatments, Paris offers a variety of options. If you're unsure about where to turn, I'm here to guide you.

The Psychological Impact of Bilingualism on Expat Mental Health

Bilingualism, for expats, is more than a tool for communication—it profoundly shapes daily life, influencing how emotions are expressed, relationships are built, and how we perceive ourselves. While the ability to speak multiple languages aids adaptability and social integration, it also introduces complexities in emotional regulation, self-expression, and feelings of cultural belonging.

Bilingualism influences not only how we speak but also how we think, feel, and process our emotions. Studies have shown that the language we use can affect decision-making, emotional intensity, and memory recall. This article explores how bilingualism can shape the expat mental health of individuals, focusing on three main areas: identity, emotional processing, and access to psychological support.

Language and Identity: The Dynamic Self

Language is intrinsically linked to identity, helping to define how we see ourselves and interact with the world. For monolinguals, this connection is typically stable as their language remains constant across contexts. However, for bilinguals—particularly expats—this connection is more fluid. Different languages can evoke distinct emotions, memories, and even shift aspects of our personalities.

Feeling Like a Different Person in Another Language

Psycholinguistics research shows that bilinguals often feel like different versions of themselves when speaking different languages. These shifts can stem from cultural associations, learned behaviors, and emotional ties to each language. For example, someone who learned a second language in a professional or academic environment may find themselves adopting a more formal or emotionally reserved tone compared to their native language.

The Mental Effort of Code-Switching

Bilingual expats often navigate the complex task of code-switching—alternating between languages based on context. While this flexibility is valuable, it demands significant cognitive effort. The constant shifting, particularly in emotionally charged or professional settings, can lead to mental fatigue, contributing to stress and anxiety—common challenges for expats adjusting to a new life abroad.

How Language Shapes Emotional Processing

Language plays a crucial role in how we process and express emotions, and for expats, understanding its impact is vital to recognizing their psychological well-being.

Emotional Distancing in a Second Language

A unique feature of bilingualism is emotional distancing, where emotions often feel less intense when expressed in a second language. This occurs because second languages are typically learned later in life, and are less closely tied to early emotional experiences. As a result, expats might find it easier to discuss difficult or traumatic topics in their second language, distancing themselves from the emotional weight of those memories. While this can be helpful in stressful situations, it can also create barriers to accessing deeper emotional states, especially in therapeutic contexts.

The Link Between Language, Trauma, and Memory

Language also influences how traumatic memories are recalled. Studies suggest that people tend to remember distressing events more vividly in the language in which they occurred. For an expat who experienced trauma in their native language, processing those memories in a second language—especially in therapy—can be challenging. In some cases, bilingual individuals may unintentionally use their second language as a coping mechanism, distancing themselves from painful memories. While this may offer temporary relief, it can impede emotional processing and prevent full confrontation of the trauma.

Psychological Challenges of Bilingualism in Expat Life

Beyond emotional processing, bilingualism affects broader psychological experiences, such as cultural belonging and access to mental health care.

Navigating Cultural Identity

Expats often feel torn between two cultures, not fully belonging to either their home country or their host country. Language is central to this experience, closely tied to social belonging and cultural identity. The concept of linguistic liminality refers to the sensation of existing between languages, which can contribute to feelings of isolation and stress. Expats may feel like outsiders in their host country if they struggle with the local language, but at the same time, they may feel disconnected from their home culture as they adapt to new linguistic and cultural environments. This liminal space can be disorienting, as one slowly settles into a new, multicultural identity.

Language Barriers in Mental Health Care

For bilingual expats, language poses both practical and emotional challenges in therapy. Since emotions are often more easily expressed in the language in which they were first experienced, discussing sensitive topics in a second language can feel disconnected or less authentic. Finding a therapist who speaks the same language is crucial for creating a comfortable and effective therapeutic environment. Yet, even when language fluency is shared, cultural differences in therapeutic approaches may still present obstacles, potentially hindering the connection between client and therapist.

Embracing a Multilingual Identity for Better Mental Health

Rather than attempting to “fit in” or feel “at home” in just one language or culture, expats can benefit from embracing the richness of their bilingual identity. Acknowledging that different emotions and memories may arise in various linguistic contexts can help expats integrate their experiences more fully, cultivating a more holistic and resilient sense of self.

Conclusion

Bilingualism, while challenging, offers a dynamic and evolving sense of self where language shapes not only communication but emotional connections and worldviews. Each language offers a new perspective, enriching identity and broadening understanding. By embracing this fluidity, expats can gain a deeper and more nuanced sense of who they are. Connecting with others who, even if they do not share the same background, understand the unique experience of navigating life between languages and cultures can provide invaluable support and create a profound sense of belonging.

I have no regrets about my choice to become an expat in Paris. My hope is to help others find community support and learn to appreciate the richness and unique advantages that this lifestyle offers.