Acupuncture in the Treatment of Trauma
Today there is more awareness of the pervasiveness of traumatic experiences within our culture. Some twenty-five years ago, when I attended medical school, it was still commonly taught that trauma and PTSD only occurred in soldiers and the survivors of terrible atrocities. Thankfully, our understanding has grown. We now know that any experience that overwhelms our individual strategies and abilities to cope in the moment is potentially traumatic. In addition to discrete or ongoing traumatic events, there are also types of trauma that result from what was missing from one's environment - such as certain forms of care and nurturance.
We are living in a time of more nuanced trauma understanding. For many, we live in a time when the realities of daily existence are overwhelming and potentially trauma-inducing. The demands on our attention are constant: endless streams of information, life-altering pandemics, ecological disruption, increasing economic precarity, and the continuous stream of mass shootings and racialized violence. It can be overwhelming.
The impacts and presentation of trauma are varied and can include: disrupted sleep, anxiety, depression, headaches, functional digestive disorders, hypervigilance, impaired immune response, and amplifications of chronic and acute pain.
A variety of treatments are commonly employed to address trauma across the spectrum of presentations. These include:
Trauma-informed mental health therapy - including a variety of methods that have particular applicability in trauma, such as EMDR and Somatic Experiencing.
Pharmacologic therapy with medications to treat anxiety, depression, and sleep disorders
Various body-based therapies such as yoga, dance therapy, expressive arts therapies, etc.
It is good to have options, and all of these may be appropriate and effective for some. It is worth noting that the need for high-quality, trauma-informed mental health therapy often exceeds its availability. Many people may lack insurance coverage or the financial means to cover the cost of such therapy. For some, pharmacologic therapy may be an effective option to manage symptoms, ideally while accessing mental health therapy. However, many people are adamantly opposed to the use of medication. Many body-based therapies can be helpful adjuncts or even the central component of care, especially when administered within the context of a supportive community.
Acupuncture is another modality that can effectively address many aspects of trauma. Acupuncture is one component within the larger framework of Asian and Acupuncture Medicine (AAM). Acupuncture treatment supports the balanced flow of energy, known as Qi. Trauma can be seen as precipitating a disruption in the flow of Qi. By stimulating various acupuncture points located on the acupuncture channels of the body, acupuncture can restore the balance and flow of Qi.
From a biomedical standpoint, there are many theories regarding how acupuncture works, and it likely works through multiple mechanisms, including:
Release of endorphins
Modulation of various brain regions that can reduce sensitivity to pain and stress
Impacts on neurotransmitters
Impacting cell signaling chemistry to reduce the release of inflammatory cytokines, which are associated with stress responses
Western Medicine, with its anatomic and biochemical approach, has noted that in trauma, specific brain centers that are important for reasoning and decision making, such as the prefrontal cortex, are down-regulated or less active. In contrast, other areas of the brain that are associated with fear and threat response, such as the amygdala, are upregulated or more responsive. Both contribute to the challenges with threat appraisal and rational decision-making that characterize trauma spectrum responses. In addition, there is the elaboration of many inflammatory cytokines (cell signaling chemicals) that can drive a chronic inflammatory reaction - contributing to a myriad of potential presentations, including increased pain, sleep disruption, etc.
Acupuncture can support and address many of the symptoms in people experiencing the impacts of chronic stress or trauma. Auricular acupuncture is an option to address anatomic or functional concerns through needling and stimulation of ear points. The basis of auricular acupuncture is the recognition that the ear provides a projection of the whole organism and its function on the ear. (In other words - it is possible to treat the entire body using the ear - truly the macrocosm in the microcosm!). Stimulating ear points that are a part of specific auricular acupuncture for trauma treatment protocols modulated the function of several of the brain centers involved in the trauma response (Helms). For decades, an auricular acupuncture treatment protocol has been an effective adjunct to substance abuse treatment (Bemis). These protocols provide examples of how acupuncture may represent an accessible and potentially effective component of trauma treatment and support. In addition to protocolized treatments, individualized auricular and body-based acupuncture treatments based on an individual's unique history and presentation are frequently employed.
Works Cited
Bemis, Ryan. “Evidence for the NADA Protocol: Summary of Research - NADA.” National Acupuncture Detoxification Association, 2013, https://acudetox.com/evidence-for-the-nada-protocol-summary-of-research/. Accessed 7 August 2022.
Helms, Joseph M. “HMI Auricular Trauma Protocol: An Acupuncture Approach to Trauma Spectrum Symptoms.” Medical Acupuncture, vol. 23, no. 4, 2011, pp. 209-13.
Dr. Nicole Winbush is a board-certified Family Medicine Physician practicing Integrative/Functional Medicine, Medical Acupuncture, and the founder of Sankofa Healing Arts & Functional Medicine.
Sankofa Healing Arts & Functional Medicine will provide medical acupuncture (both auricular and body-based) treatment as part of our integrated, holistic care model to support individuals dealing with trauma as well as a wide variety of other health and wellness concerns. For questions or inquiries, please send a message to contact@sankofahealingarts.com.
