How Trauma Shows Up in Adulthood (Trauma Series Part 4)
By Nhi Vo, LMSW | Clove Counseling, Lisle IL
Sometimes people ask, “If my trauma happened a long time ago, how can I still be affected by it?”
Trauma does not always show up as a clear flashback or vivid memory. More often, it appears in patterns: in how we feel, react, relate, and see ourselves.
In this post, we will look at some of the most common ways trauma shows up in adulthood. If you see yourself in any of these, it does not mean you are broken. It means your body has a story to tell.
Trauma In the Body
Trauma is as much a body experience as an emotional one. Research on adverse childhood experiences shows that children and adults with a history of early adversity are more likely to report chronic pain, and that risk tends to increase as the number of adversities goes up ¹.
Many people with chronic pain conditions, including fibromyalgia, also report higher rates of childhood trauma and adverse childhood experiences. These early experiences may increase inflammation and sensitize pain pathways, which can contribute to long term pain and greater pain intensity².
People who have experienced trauma or live with posttraumatic stress also appear to be at higher risk for certain health problems, including autoimmune and inflammatory conditions. Studies suggest that PTSD is associated with changes in the immune system, higher levels of inflammatory markers, and an increased likelihood of developing autoimmune disease over time³ .
This can look like:
chronic muscle or joint pain
frequent headaches or migraines
irritable bowel or other digestive issues
getting sick often or taking longer to recover
feeling worn down even when you are “doing everything right” for your health
Not all chronic pain or illness is caused by trauma, and it is important not to blame yourself or your history for every symptom. At the same time, for many people, understanding that their body may be carrying the long term effects of stress and adversity can be a relief. It can shift the story from “My body is failing me” to “My body has been trying to protect me for a very long time and now needs some extra care to recover.”
Trauma Showing Up In Emotions
Trauma can make emotions feel:
too big, like overwhelming waves, or
too small, like numbness or emptiness
You might notice:
frequent anxiety or dread
sudden anger or irritability that feels out of proportion
shame that appears quickly and intensely
feeling “too sensitive” or “not sensitive enough”
These emotional patterns often formed when feelings were not met with safety or understanding earlier in life⁴ ⁵.
Trauma Showing Up In Thoughts & Beliefs
Trauma often leaves behind stories about who we are and what we deserve, for example:
“I am not good enough.”
“It is my fault.”
“I am too much for people.”
“If I need others, I will be abandoned.”
“I have to be perfect or I will be rejected.”
These beliefs can shape how we see ourselves in every area of life, even when we logically know they are harsh or unfair.
Trauma Showing Up In Relationships
Because our first relationships are often where trauma occurs or goes unaddressed, it makes sense that it shows up in adult relationships:
difficulty trusting others
avoiding talking about yourself or your feelings in relationships
staying in unsafe or unfulfilling relationships
avoiding closeness for fear of being hurt
feeling overly responsible for others’ feelings
people-pleasing or caretaking at your own expense
intense fear of conflict or abandonment
These patterns often reflect early attachment experiences, times when connection felt unreliable, conditional, or unsafe ⁶ .
Trauma Showing Up In Coping & Behavior
Trauma can also appear in how we cope when we feel overwhelmed:
overworking or overachieving
substance use or other numbing behaviors
self-harm or disordered eating
compulsive caretaking
difficulty setting boundaries
staying busy all the time to avoid feelings
These are not moral failings. They are strategies that once helped you survive or stay connected.
Trauma Showing Up In Identity & Sense of Self
Many people with trauma histories describe feeling:
unsure who they really are
like they are “performing” a version of themselves
disconnected from their own preferences, needs, or desires
like they are always “too much” or “not enough”
Complex and developmental trauma are strongly associated with difficulties in identity and self-worth⁷ ⁸.
Coming Next: Part 5—What Healing Trauma Actually Looks Like
In the final part of this series, we will talk about what healing actually looks and feels like and how therapy can support that process.
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(Or check back soon — new posts are on the way.)
Curious About Trauma Therapy at Clove Counseling?
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References
Groenewald, C.B., et al. (2020). Adverse childhood experiences and chronic pain among children and adolescents in the United States. PAIN Reports.
Nicolson, K. P., et al. (2023). What is the association between childhood adversity and subsequent chronic pain in adulthood? A systematic review. BJA Open.
Sun, Y., et al. (2021). The Relationship Between Inflammation and Post-traumatic Stress Disorder. Frontiers in Psychiatry.
Schore, A. N. (2019). Right Brain Psychotherapy. W. W. Norton.
Kim, S., et al. (2020). Childhood emotional neglect and adult mental health: A meta analytic review. Clinical Psychology Review.
Crittenden, P. M. (2016). Raising Parents: Attachment, Parenting, and Child Safety (2nd ed.). Routledge.
Ford, J. D., & Courtois, C. A. (2020). Treating Complex Traumatic Stress Disorders in Adults (2nd ed.). Guilford Press.
Cloitre, M., et al. (2014). The ISTSS Expert Consensus Treatment Guidelines for Complex PTSD in adults. International Society for Traumatic Stress Studies.
