Trauma Counselling in Nanaimo & Virtually

At Soma House Counselling & Wellness, we understand that trauma isn’t just about what happened to you — it’s about what happened inside you as a result. Trauma is the body and brain’s natural response to experiences that feel overwhelming, threatening, or beyond your ability to cope.

When something happens that shakes your sense of safety or control, your nervous system automatically shifts into survival mode to protect you. These responses are not choices; they are built-in biological survival mechanisms designed to keep you safe (Porges, 2011; van der Kolk, 2014). Sometimes, however, those protective responses remain active long after the danger has passed.

You may find yourself feeling anxious, emotionally numb, disconnected, constantly on edge, or struggling with symptoms that don't seem connected to the original experience.

Healing begins with safety.

Our biopsychosocial, trauma-informed, and neuroscience-informed approach helps clients understand the impact of trauma on the brain, body, nervous system, relationships, and daily functioning while developing the tools needed to move toward healing and recovery.

Trauma affects everyone differently.

For some people, its impact is obvious. For others, it hides behind coping strategies that once helped them survive. You might notice:

• Feeling anxious, tense, or constantly on edge
• Trouble sleeping, nightmares, or intrusive memories
• Avoidance of certain people, places, thoughts, or situations
• Feeling detached, numb, or disconnected from yourself or others
• Difficulty trusting others
• Trouble concentrating or remembering things
• Emotional overwhelm or difficulty regulating emotions
• Persistent feelings of shame, guilt, or self-criticism
• Chronic fatigue, exhaustion, or burnout
• Physical symptoms such as headaches, chronic pain, digestive concerns, or muscle tension
• Hypervigilance or always anticipating something bad will happen

These are not signs of weakness.

They are signs that your nervous system has been working hard to protect you (SAMHSA, 2014; van der Kolk, 2014).

When something overwhelming or threatening happens, the body automatically shifts into survival mode through nervous system responses commonly known as fight, flight, freeze, fawn, or shutdown (Porges, 2011).

These responses are designed to help us survive danger. However, when the threat has passed but the nervous system remains activated, trauma symptoms can persist.

Research has shown that PTSD and trauma are associated with changes in several key brain regions involved in threat detection, memory processing, emotional regulation, and decision-making (Bremner, 2006; Shin et al., 2006). Studies suggest that trauma can:

• Increase activation of the amygdala, the brain's alarm system responsible for detecting danger (Shin et al., 2006)
• Affect the hippocampus, which helps organize and process memories (Bremner, 2006)
• Reduce the efficiency of the prefrontal cortex, which supports emotional regulation, planning, and rational decision-making (Shin et al., 2006)
• Increase hypervigilance and sensitivity to perceived threats (National Center for PTSD – PTSD Neurobiology)
• Disrupt sleep, digestion, energy levels, and mood through ongoing nervous system activation (Porges, 2011; van der Kolk, 2014)

This helps explain why trauma often shows up physically, not just emotionally. Many people experience chronic tension, exhaustion, pain, digestive issues, headaches, panic symptoms, or a constant sense of being "on alert" (van der Kolk, 2014).

As van der Kolk (2014) describes, trauma affects both the brain and body. Healing often requires approaches that support emotional processing, nervous system regulation, and the restoration of a sense of safety.

Many people expect trauma to look like flashbacks, panic attacks, or emotional breakdowns. Sometimes it does. Other times, trauma hides behind behaviours that are often praised or rewarded. Trauma can look like:

• Being the person everyone depends on
• Constantly staying busy
• Overworking
• Perfectionism
• People-pleasing
• Taking care of everyone except yourself
• Difficulty resting or slowing down
• Hyper-independence
• Emotional numbness
• Burnout
• Difficulty trusting others
• Always anticipating problems

Many people spend years believing these patterns are simply personality traits when they may actually represent adaptive survival responses developed in response to adversity, trauma, or chronic stress (Herman, 1992; van der Kolk, 2014).

PTSD is recognized within the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and may develop following exposure to actual or threatened death, serious injury, or sexual violence (APA, 2022). Common symptoms include:

• Intrusive memories
• Flashbacks
• Nightmares
• Avoidance of reminders
• Hypervigilance
• Heightened startle response
• Sleep difficulties
• Anxiety and fear

Complex PTSD is recognized within the International Classification of Diseases (ICD-11) and typically develops following repeated, prolonged, or relational trauma where escape is difficult or impossible (WHO ICD-11, 2019/2022; Brewin et al., 2020). Examples may include:

• Childhood abuse or neglect
• Domestic violence
• Coercive control
• Emotional abuse
• Human trafficking
• Repeated interpersonal betrayal
• Chronic exposure to unsafe environments

In addition to PTSD symptoms, individuals living with Complex PTSD may experience what ICD-11 refers to as disturbances in self-organization, including difficulties with emotional regulation, a persistently negative self-concept, and ongoing relationship difficulties (Karatzias et al., 2018; Cloitre et al., 2013). People may also experience:

• Persistent shame, guilt, or self-blame
• Emotional flashbacks
• Difficulty regulating emotions
• Chronic anxiety or fear
• Negative self-image
• People-pleasing and difficulty setting boundaries
• Fear of abandonment or rejection
• Challenges with trust and intimacy
• Dissociation or feeling disconnected from themselves
• A persistent sense that something is fundamentally wrong with them

(Herman, 1992; Cloitre et al., 2013; Karatzias et al., 2018).

For many individuals with Complex PTSD, healing involves rebuilding self-trust, strengthening boundaries, developing emotional regulation skills, and creating a greater sense of safety within relationships and within themselves.

Many people living with PTSD or Complex PTSD do not fit the stereotypical image of trauma. They go to work, care for their families, help others, lead teams, and succeed professionally.

From the outside, they often appear calm, capable, dependable, and highly functional.

Inside, however, they may be carrying significant nervous system activation, emotional distress, and chronic survival responses.

Although High-Functioning PTSD is not a formal diagnosis, many individuals continue to function at a high level while experiencing significant trauma-related symptoms beneath the surface (Herman, 1992; van der Kolk, 2014). You may identify with High-Functioning PTSD if you:

• Feel constantly "on" or unable to relax
• Anticipate problems before they happen
• Struggle to rest without guilt
• Overwork or over-function for others
• Have difficulty asking for help
• Feel responsible for everyone around you
• Experience chronic anxiety despite appearing successful
• Struggle with perfectionism
• Feel emotionally disconnected or numb
• Experience recurring burnout or exhaustion

For many people, these patterns developed as survival strategies. What once helped you adapt and stay safe may now be contributing to stress, relationship difficulties, health concerns, and emotional exhaustion (Herman, 1992; van der Kolk, 2014).

Burnout and High-Functioning PTSD can look similar on the surface, but they are not the same thing.

Burnout is typically associated with chronic workplace stress, exhaustion, cynicism, and reduced effectiveness. High-Functioning PTSD often includes many of these symptoms but is rooted in unresolved trauma and survival responses that continue long after the original threat has passed.

Many people seek support for anxiety, stress, perfectionism, or burnout only to discover that trauma may also be playing a significant role in how they think, feel, relate, and cope.

Trauma affects people from all walks of life, including those who spend their lives helping others, such as:

• First Responders
• Veterans
• Military Members
• Healthcare Professionals
• Educators
• Emergency Managers
• Public Safety Personnel
• Professional Helpers
• Caregivers
• Leaders in High-Stress Roles

Research has consistently shown higher rates of trauma exposure, PTSD symptoms, burnout, moral injury, and operational stress injuries among helping professions and trauma-exposed occupations (Haugen et al., 2017).

Many individuals in these professions become highly skilled at functioning under pressure while their nervous systems remain activated and focused on potential threats.

Because these coping strategies are often rewarded professionally, trauma-related symptoms can go unrecognized for years.

Healing doesn’t mean forgetting what happened — it means learning to live fully again.

Through evidence-based and body-based therapies such as EMDR (Eye Movement Desensitization and Reprocessing), somatic awareness, Internal Family Systems (IFS),  Cognitive Reprocessing Therapy (CPT), and mind-body regulation, clients learn to reprocess distressing experiences and restore balance in their nervous system.

Begin your counselling journey with Farnaz Farrokhi-Holmes, RCC, CCC, a clinical counsellor offering in-person and virtual trauma- and neuroscience-informed counselling in Nanaimo, throughout British Columbia, and in select provinces across Canada for people navigating trauma, grief, and loss.

 American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).

Bremner, J. D. (2006). Traumatic stress: Effects on the brain. Dialogues in Clinical Neuroscience, 8(4), 445–461.

Brewin, C. R., Cloitre, M., Hyland, P., et al. (2020). Complex post-traumatic stress disorder: A new diagnosis in ICD-11. World Psychiatry, 19(1), 84–85.

Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2013). Evidence for proposed ICD-11 PTSD and Complex PTSD. World Psychiatry, 12(3), 186–194.

Haugen, P. T., Evces, M., & Weiss, D. S. (2017). Treating PTSD in first responders: A systematic review. Clinical Psychology Review, 51, 1–15.

Herman, J. L. (1992). Trauma and Recovery.

Karatzias, T., Hyland, P., Bradley, A., et al. (2018). Risk factors and disturbances in self-organization in ICD-11 Complex PTSD. Journal of Affective Disorders, 232, 273–281.

National Center for PTSD. PTSD Neurobiology.

National Center for PTSD. Complex PTSD: History and Definitions.

Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic Experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6, 93.

Porges, S. W. (2011). The Polyvagal Theory.

SAMHSA. (2014). SAMHSA's Concept of Trauma and Guidance for a Trauma-Informed Approach.

Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy (3rd ed.).

Shin, L. M., Rauch, S. L., & Pitman, R. K. (2006). Amygdala, medial prefrontal cortex, and hippocampal function in PTSD. Annals of the New York Academy of Sciences, 1071, 67–79.

VA/DoD Clinical Practice Guideline Working Group. (2023). VA/DoD Clinical Practice Guideline for the Management of PTSD and Acute Stress Disorder.

van der Kolk, B. A. (2014). The Body Keeps the Score.

World Health Organization. (2019/2022). International Classification of Diseases (11th Revision; ICD-11).