Trauma’s Lasting Echoes: High-Functioning Trauma and the Biology of Survival

June is PTSD Awareness Month, and with it comes the opportunity to deepen our understanding of trauma’s lasting imprint on the mind, body, and spirit. While "PTSD" has become a more recognized term in public discourse—especially among veterans, first responders, and survivors of abuse there remains a powerful need to differentiate Post-Traumatic Stress Disorder (PTSD) from Complex PTSD (CPTSD), as well as to explore how trauma overlaps with complicated grief, developmental trauma, ADHD and even traits we often applaud—resilience, moral courage, and superhuman tenacity (X-Men club). 

Beyond the Diagnosis: PTSD vs. CPTSD PTSD typically arises after a single shocking or life-threatening event—a car accident, assault, natural disaster, or battlefield trauma. CPTSD, on the other hand, develops from repeated, prolonged trauma, especially during vulnerable developmental stages such as childhood. This might include emotional neglect, abuse, abandonment, or growing up in a chaotic or unsafe environment. 

Shared Core Symptoms: 

• Intrusive memories or flashbacks, body sensations, and visceral feelings
• Avoidance of reminders of the trauma
• Hyperarousal and heightened startle response
• Negative changes in mood and cognition

 What Sets CPTSD Apart: 

• Emotional dysregulation (ANS/Polyvagal Theory)
• Persistent negative self-beliefs (“I’m broken,” “I’m unlovable” Core self is still forming and or is fragmented in time due to trauma imprints.
• Difficulty in relationships (relational/betrayal trauma/trust & attachment issues)
• Chronic feelings of emptiness or despair (impending doom/ negative or distorted worldview, and death imprint)

People with CPTSD often carry developmental wounds that predispose them to re-traumatization, especially in high-stakes or emotionally intense relationships re-enacting upbringings, in partner relationship, even intense and high-risk environments at work like healthcare, law enforcement, or firefighting. 

The Invisible Wounds of Moral Injury & Survivor’s Guilt Trauma isn’t always about what happened to you. Sometimes it’s about what you had to do, couldn’t do, or witnessed happen to others. How the event imprints on your mind and body, meaning making, smells, sounds, pictures, statements/comments, felt sense, and the state you are in when it happens. And does it overlap or feel like, look like or sound like other cumulative traumas as the brain reticular activating system and amygdala scans based on previous experiences, imprinting familiar and patterns. Example: “I had to something against my moral code but it was an order or it was the procedure etc. I should have or should not have been there when that thing happened and why did I survive and no-one else did.” 

• This is where moral injury and survivor’s guilt emerge. These wounds often live beneath conscious awareness, and present in thoughts, body sensations, and in ones’ felt sense (visceral and mind body feedback loop cocktail of neurochemistry when recalled or re-experienced. However, they can manifest as deep shame, existential dread, and emotional pain that resists logic. These are separate systems the body (vessel cannot know what your mind and core beliefs are and your heart can’t know your thoughts and if the chemistry created is not real, rather a perception or interpretation of reality through one’s lens- what we think is powerful neurobiological chemistry we can override and control our actions, challenge our beliefs and use inquiry of how this is the same or different to update our brains software so to speak).
•  A parent cannot on face and connect in a healthy way a secure attachment bond with a child due to their own trauma or a dysregulated nervous system leaves the child feeling less than, something must be wrong with me, I’m not lovable, not enough, not valuable based on the non-verbal cues and verbal responses from the parent. A firefighter who couldn’t save a child. A nurse overwhelmed by pandemic losses. A soldier haunted by decisions made in war. Without inquiry and support, these wounds fester in silence—and that silence can become lethal.  For many this is the correlation with high Adverse Childhood Experiences score that lead to diseases, chronic illness, substance use, suicidal ideation and early death. This is why mind-body therapies can create lasting change and healing by Disentangling the roots that bind!  (book coming soon).

Traumatic Loss, Complicated Grief & the Need to Mourn When trauma and grief collide—such as a traumatic death—the grieving process can become complicated, tangled with guilt, rage, blame, psychological shock, surreal, or Freeze state in Polyvagal theory, dissociation or the blank zoned out stare feeling when someone is feeling really far away and checked out. In these cases, time doesn’t “heal all wounds.” It buries them. We have to reset, reboot, restore our autonomic nervous system this is fundamental here at Integrative NeuroCounseling. 

Complicated grief is more likely to occur: 

• After sudden, violent, or preventable deaths
• When the mourner felt responsible or helpless
• When cultural or personal meaning is shattered

This unresolved mourning can mimic PTSD or coexist with it, especially when the nervous system becomes locked in sympathetic dominance or low parasympathic (neurobiological not having enough ATP and energy for basic tasks and no appetite, anhedonia and other physical symptoms are within normal limits of grief especially someone close to you may take up to two years for the nervous system to recover. You may have read or have seen a couple married for 40 years and they die a few months apart from broken heart syndrome. Some people cannot eat, get out of bed, shower and long to be with the deceased or have difficulty moving through NOT getting over the loss…. 

Critical Incident Debriefing: A Bridge Between Head, Heart & Gut Supportive interventions like Critical Incident Stress Debriefing (CISD) and trauma-informed counseling can help integrate the conscious and subconscious minds—and restore balance between our head (logic/cognitive processes), heart (emotion/core self “emoting”), and gut (instinct/safety and self-preservation). When processed safely (co-regulation with a caring person to bear witness to and hold space for, trauma can become a catalyst for post-traumatic growth. But left untreated, it can lead to: emotional shutdown, burnout, substance use, high risk behaviors and/or avoiding chronic health issues, suicidal ideation, severe agitation, anger, injustice and isolation. 

Wired to Serve: The Double-Edged Sword of Epinephrine and Early Trauma 

High-stress professions attract people with unique neurological wiring—often those with high ACE scores (Adverse Childhood Experiences), ADHD traits, or histories of trauma themselves. These individuals may be: 

• Sympathetic dominant (high adrenaline, always “on”, run by a motor, “wired and tired”).
• Epinephrine-seeking (thrill-driven, intense focus under pressure, high risk, internal locus of control in high rates, believing you can do hard things others cannot).
• Hyper-capable under stress but struggle with boredom, sleep, daily routines.

This paradox creates a population that can run into a fire but forget to eat, rest, or feel joy. When these high performers hit a wall, they often do so hard, leading to anhedonia, isolation, and burnout. We must reframe help-seeking as strength (vulnerability expands the cortex), not weakness—and recognize that the same neurobiology that equips people to save lives can, without care, slowly destroy their own. 

Resilience: More Than a Buzzword PTSD is not the end of the story. It changes biology—yes—but it also awakens resilience genes, especially with the right support. Resilience is not just about “bouncing back”—it’s about learning to bend without breaking, (visualize a weeping willow tree in a storm) to stay rooted during emotional storms. Resilience is not only shaped by life experience but also influenced by epigenetics, inherited biological patterns, and conditioning from enculturation in childhood-adolescents.  

ADHD and PTSD frequently overlap due to shared neurobiological and genetic factors. Variants in genes such as FKBP5, COMT, BDNF, SLC6A3 (DAT1), SLC6A4, and DRD4 influence dopamine and serotonin regulation, stress reactivity, and executive functioning—contributing to symptoms like impulsivity, hypervigilance, and emotional dysregulation. These predispositions often lead individuals gravitate towards high-intensity, purpose-driven roles and service-oriented roles (e.g., law enforcement, firefighting, healthcare), where their energy, resilience, and desire to help others are well-matched—but where trauma exposure is frequent. Epigenetic modifications, particularly in FKBP5 and BDNF, can further amplify vulnerability to PTSD under chronic stress. 

Understanding these genetic and environmental interactions is critical for developing targeted prevention, early intervention, and support strategies for those at higher risk. Research has identified several genes—such as FKBP5, COMT, BDNF, SLC6A4 (serotonin transporter gene), and DRD4 (dopamine receptor gene)—that play significant roles in how we respond to trauma, stress, and adversity.  Family history matters: if generations before us faced trauma, those experiences can alter gene expression through epigenetic markers—essentially passing down both burdens and breakthroughs. Some people, thanks to a complex interplay of genetics, upbringing, and adaptive neuroplasticity, are biologically more equipped to do extraordinary things under pressure that others might find debilitating. Understanding these gene-environment interactions opens doors to personalized approaches to healing, performance, and mental health resilience. 

Honor the Wound and the Warrior Many who live with PTSD or CPTSD are the unseen heroes among us—taking on roles others avoid, carrying emotions others suppress, and surviving pain most never recognize. First responders see anywhere from 200-1000 critical incidents in a 30-year career while most people see 1 or 2 in their lifetime. The cumulative nature alone is daunting. They are the first to respond, the last to rest, and often the ones left holding invisible scars.  

This June 2025 PTSD Awareness Month, let’s commit to: 

• Normalizing asking for help—because strength includes vulnerability.
• Understanding the complexity of trauma and grief—not just its symptoms.
• Ending the pathologizing of high-energy, neurodiverse helpers—and recognizing their resilience.
• Creating spaces for healing, growth, and authentic connection—where stories are heard/disentangled, not silenced.

 You are not broken—you are becoming!

Nichole Oliver LPC, NCC, DAAETS