The Wounded Healer’s Lens: Unpacking Medical Trauma and Nervous System Dysregulation
Introduction: Re-framing Mental Health Through a Trauma-Informed, Physiological Lens
Traditional narratives surrounding mental health often center on psychological predispositions or genetic vulnerabilities. While these factors are undeniably significant, a comprehensive understanding necessitates broadening this perspective to include the profound physiological impacts of medical interventions and environmental elements, particularly during critical developmental periods. The Wounded Healers Institute posits that authentic healing requires an understanding of the whole person, including the body’s intricate responses to stress and harm. From this vantage point, expressions of mental health, including states of dissociation, may not solely represent psychological coping mechanisms. Instead, they can be viewed as deeply rooted physiological adaptations to overwhelming experiences, especially those encountered within medical contexts from early life.
Early Life Interventions & Nervous System Foundations
The formative experiences of early life, spanning from conception through infancy, exert a profound influence on the developing nervous system, potentially leading to dysregulation and a heightened susceptibility to trauma responses. Trauma, particularly when experienced during childhood, significantly disrupts neural circuits that are vital for emotional regulation, cognitive functions, and stress management. This disruption can lead to a hyperactive hypothalamic-pituitary-adrenal (HPA) axis, resulting in increased and often dysregulated release of cortisol, a stress hormone known to alter brain structures such as the hippocampus, prefrontal cortex, and amygdala. Such alterations render individuals more reactive to stress and less capable of emotional regulation.
Research identifies a “Perfect Storm” of factors contributing to nervous system dysregulation in children, often commencing even before birth. This confluence of stressors includes preconception and prenatal stress, birth trauma and interventions, and early exposure to various toxins and chemicals. When a mother experiences chronic stress, elevated levels of stress hormones like cortisol can cross the placenta, altering the developing baby’s nervous system and increasing susceptibility to dysregulation. Traumatic births, frequently involving interventions such as forceps, vacuum extraction, or cesarean section, can inflict physical stress and injury on a baby’s delicate nervous system by disrupting crucial brain-body communication in the brainstem area. This disruption to the brainstem, which functions as a central control system for the nervous system, can impair its ability to regulate nearly every aspect of health and development.
The Neonatal Intensive Care Unit (NICU) environment presents another significant source of early life medical trauma. While survival rates for very premature infants have improved, neurodevelopmental outcomes have not seen a commensurate improvement, with problems in behavior, executive functions, and learning remaining highly prevalent. Pain-related stress in the NICU contributes significantly to long-term neurodevelopmental problems and nervous system dysregulation. The immature nervous system of preterm infants responds uniquely to pain, and repeated painful procedures during critical developmental periods—corresponding to the late second and entire third trimester of fetal life—induce diffuse activation across multiple brain regions.
The mechanisms through which NICU experiences impact neurodevelopment are multifaceted. Preterm neonates exhibit lower touch thresholds and greater reflex responses to touch, indicating a sensitization to sensory input. This sensitization, particularly in infants below 33 weeks postmenstrual age, means even non-invasive handling can elicit pain-like responses, establishing a pathway for ongoing discomfort. Skin-breaking procedures in the NICU evoke widespread, non-specific neuronal bursts of EEG activity across the brain in preterm infants, unlike the localized responses seen in full-term neonates. This broad reactivity highlights the vulnerability of the preterm brain. Studies using advanced MRI have shown that higher pain-related stress, quantified by the number of skin-breaking procedures, correlates with poorer neonatal brain development, including reduced white matter and subcortical grey matter. Furthermore, repeated neonatal pain contributes to altered programming of the HPA axis, leading to dysregulated cortisol levels that can impact brain function.
Beyond changes in somatosensory processing, early injury leads to more complex cognitive and behavioral alterations. This includes increased sensitivity to noxious stimuli and greater pain requirements during subsequent surgeries. Internalizing behaviors, prevalent in children born preterm, have been observed to persist into adolescence and beyond.
A key observation emerging from these findings is the profound influence of the developmental period during which trauma and stressors occur. The consistent evidence indicates that early, repeated medical interventions and stress do not merely cause acute pain; they fundamentally shape the developing nervous system, leading to chronic dysregulation. The brain’s crucial structures—the amygdala, prefrontal cortex, and HPA axis—and its fundamental stress response are literally “wired” differently. This establishes a baseline for future mental health expressions, suggesting that many adult mental health conditions, often attributed solely to later life events or genetics, may have deep roots in unacknowledged early medical trauma and its neurobiological consequences. This perspective shifts the inquiry from “what is wrong with an individual?” to “what happened to their developing nervous system?”
Another significant understanding is how dissociation can serve as a physiological survival mechanism. While direct links between early medical trauma and dissociation are not always explicitly stated in some sources, the symptoms of nervous system dysregulation—such as hyperarousal, hypoarousal, cognitive issues, and emotional difficulties—are precisely the conditions that would necessitate such a coping strategy. Dissociation is a mind’s coping mechanism for “too much stress” or “unbearable trauma,” enabling a child to “psychologically escape” when physical escape is impossible. The dysregulated nervous system resulting from early medical trauma, like NICU pain or birth trauma, creates an internal environment of chronic overwhelm. When the body’s fight-flight-freeze response is overwhelmed and neither fighting nor fleeing is an option, the “freeze” response, which encompasses dissociation, becomes the default survival strategy. This reframes dissociation, often pathologized, as an intelligent, albeit potentially maladaptive, physiological adaptation to overwhelming medical or early life stress. Understanding this connection is crucial for trauma-informed care and interventions, particularly for conditions like autism, where dissociative traits are increasingly recognized.
Iatrogenic Trauma: When Healing Causes Harm
Iatrogenic trauma refers to the long-term suffering and distress directly caused by medical treatment itself. This can stem from poorly executed, mistaken, or incompetent treatment of any painful, limiting, or frightening mental or medical problem. It includes unrealistic optimism, unfulfilled assurances of relief or cure, treatment failure, the worsening of a condition, painful complications, or the creation of unanticipated, unrelated conditions. When indirect knowledge can be considered qualitative or lived experience, it is as valid as direct conditions because the conditions are repeating and observers who have been here longer can know outcomes; thus causation in indirect actions taken can be seen. Without reading into intention, objective reality can be known because we know who knows what. Additionally, it encompasses injuries resulting from medical advice, such as inappropriate drug usage.
Beyond individual errors, iatrogenic trauma can also arise from systematic ignorance of a medical or mental health problem, stigmatizing and shaming labels, and the lack of effective treatment. A historical illustration is the term “schizophrenia,” coined in 1911 by Dr. Paul Eugen, which translated to “split mind” in Latin. His incomplete understanding led to widespread treatment protocols that offered little relief and often exacerbated patients’ suffering. Such labels can be demeaning and inaccurate, contributing to the trauma.
A critical consequence of iatrogenic trauma is the profound loss of trust experienced by the patient in the treatment provider and often the entire medical field, which can lead to a refusal to seek life-saving care in the future. While not always a result of medical error or negligence, iatrogenic conditions can indeed stem from mistakes in surgery, incorrect prescriptions, or faulty procedures. However, even the intrinsic and sometimes unavoidable adverse effects of necessary medical treatments, such as hair loss or nausea from chemotherapy, are classified as iatrogenic. The evolution of antibiotic resistance due to over-prescription is another example of iatrogenic harm.
The concept of iatrogenic dissociation specifically highlights how medical examination or treatment can cause or shape dissociative states. The “sociocognitive model,” for instance, posits that Dissociative Identity Disorder (DID) can be iatrogenic, suggesting that if a therapist uses hypnosis or explicitly suggests the presence of other personalities, some patients might develop DID symptoms in response to these suggestions. However, with qEEG, fMRI, Neuroscience, and neuroregulation, this can no longer be the science of the law because dissociation is known as shutdown and experientially, because dissociation is common, normal, and supposed to happen under conditions of stress, then the basis of nature being organics (e.g., our rings of the tree analogy); if biology is anything, it is memory (O’Brien, 2023a; O’Brien, 2025). When the body has a story to tell and feels safe and regulated enough to share it, then it is the reality that is that needs to be lived.
A fundamental observation here is the inherent paradox of medical intervention: the very systems and interventions designed to heal can, through various mechanisms—ranging from incompetence and error to unavoidable side effects or even the approach to therapy—cause profound and lasting harm. This harm is not merely physical; it leaves “permanent psychological scars” and contributes to “long-term suffering and distress”. The erosion of patient trust is a particularly damaging consequence, as it can lead to a cycle of avoidance and potentially worsen health outcomes. This points to a systemic issue that requires a critical re-evaluation of medical training, diagnostic practices, and patient-provider relationships. It calls for a shift towards more trauma-informed and patient-centered care, where the potential for harm is rigorously assessed, communicated transparently, and patient trust is actively cultivated and maintained.
Another important understanding relates to the suggestibility of dissociation within medical contexts. If therapeutic suggestions can induce dissociative symptoms, then the broader medical environment, with its inherent power dynamics, the patient’s vulnerability, and often overwhelming procedures (especially in early life), could also inadvertently shape or amplify dissociative responses. While the research specifically mentions psychotherapy, the principle that the mind structures coping mechanisms in response to perceived threats or external cues could extend to invasive medical procedures or chronic illness experiences. This observation urges caution in how medical conditions, particularly those involving mental health, are diagnosed and discussed. It emphasizes the critical importance of language, therapeutic approach, and avoiding leading questions that might inadvertently reinforce or create dissociative patterns. For the Wounded Healers Institute, this reinforces the need for highly sensitive, non-pathologizing approaches to mental health.
Connecting the Dots: How Early Medical Trauma Can Set the Stage for Nervous System Dysregulation and Trauma Responses, Including Dissociation
The preceding discussions reveal direct and indirect pathways through which early medical trauma contributes to chronic nervous system dysregulation and the emergence of dissociative states. The “Perfect Storm” of preconception stress, birth trauma, and early exposure to toxins creates a foundational nervous system dysregulation from the earliest moments of life. This dysregulation is further exacerbated by painful and invasive medical procedures in infancy, such as those frequently experienced in the NICU.
These early experiences fundamentally alter brain development, impacting key regions responsible for emotion, cognition, and stress regulation, including the amygdala, prefrontal cortex, and HPA axis. The result is a nervous system prone to either hyperarousal (fight/flight) or hypoarousal (freeze/numbness), making individuals more reactive to stress and less capable of emotional regulation. When confronted with overwhelming stress or trauma that cannot be physically escaped, the mind’s defense mechanism of dissociation is activated. This “psychological escape” can become deeply ingrained, leading to chronic feelings of disconnection, memory gaps, or identity confusion. The concept of iatrogenic trauma further compounds this, highlighting that the very act of seeking or receiving medical care can itself be a source of profound, lasting trauma, thereby further entrenching dissociative coping mechanisms. This is particularly relevant given the potential for medical settings to be overwhelming and disempowering.
A significant understanding that emerges is the cumulative burden and systemic vulnerability imposed on the developing nervous system. It is not merely one traumatic event, but rather a convergence of multiple stressors—prenatal, birth, NICU, and general medical interventions—especially during early life, that creates a profound and systemic vulnerability to dysregulation. The interplay of physiological disruption, such as changes in the HPA axis and brain structure, and the psychological response to overwhelming, inescapable medical experiences (iatrogenic trauma) creates a fertile ground for dissociation to become a primary coping strategy. The body’s “freeze” response is a direct physiological manifestation of this cumulative burden. This understanding challenges the notion of isolated mental health diagnoses, suggesting instead a spectrum of nervous system dysregulation stemming from early life physiological and iatrogenic stressors. It implies that addressing mental health requires a multi-faceted approach that considers biological, psychological, and systemic factors, moving beyond mere symptom management to address root causes.
This framework also provides a means to bridge medical trauma to the understanding of autism as dissociation. The existing Wounded Healers Institute blog series on autism as dissociation posits that dissociative traits are central to the autistic experience. The evidence presented here demonstrates how early medical trauma leads to profound nervous system dysregulation, altered sensory processing, and cognitive and behavioral changes. These are precisely the areas often associated with autism. If early medical trauma fundamentally alters neurodevelopment and sensory integration, and if dissociation is a response to overwhelming sensory or emotional input, then it logically follows that these early medical experiences could be significant contributors to the dissociative presentations observed in autism. The “hypersensitivity to stimuli” and altered pain reactivity caused by trauma could make the world inherently overwhelming, triggering dissociative coping mechanisms. This provides a strong physiological and trauma-informed framework for understanding autism, suggesting that therapeutic approaches for autism could benefit significantly from incorporating trauma-informed nervous system regulation techniques and addressing potential iatrogenic experiences.
For more on our work and cause, consider following or signing up for newsletter or our work at woundedhealersinstitute.org or donating to our cause: HERE.
References
O’Brien, A. (2023a). Addiction as Trauma-Related Dissociation: A Phenomenological Investigation of the Addictive State. International University of Graduate Studies. (Dissertation). Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2023b). Memory Reconsolidation in Psychedelics Therapy. In Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/courses/addiction-as-dissociation-model-course/
O’Brien, A. (2023c). Path of the Wounded Healer: A Dissociative-Focused Phase Model for Normative and Pathological States of Consciousness: Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2024a). Healer and Healing: The re-education of the healer and healing professions as an advocation. Re-educational and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2024e). Path of the Wounded Healers for Thrivers: Perfectionism, Altruism, and Ambition Addictions; Re-education and training manual for Abusers, Activists, Batterers, Bullies, Enablers, Killers, Narcissists, Offenders, Parents, Perpetrators, and Warriors. Re-Education and Training Manual and Guide. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
O’Brien, A. (2025). American Made Addiction Recovery: a healer’s journey through professional recovery. Albany, NY: Wounded Healers Institute. Retrieved at woundedhealersinstitute.org/
*This is for informational purposes only. For medical advice or diagnosis, consult a professional.
