Cortisol is a major neurotransmitter (or body chemical). It’s best known as a stress chemical, which is why our first impression of cortisol isn’t a good one. But cortisol is the one responsible for regulating not just our stress response, but our blood pressure, blood sugar, metabolism, and immune system. Suffice to say, how we handle stress has a direct impact on our bodies.
My EMDR therapist once told me that the main problem for treating complex-PTSD is that we have too many “small t’s.” I asked him what he meant by that. He explained first, that both small t’s and Big T’s are equally valid traumas. The problem for us is that we endured so much trauma, we had no choice but to minimize it. In other words, the traumas that were a part of our daily lives became our small t’s. Once I started researching body chemicals, his words slammed home. I understood the science of our small and Big T’s and what we could do about our small ones.
Cortisol doesn’t work alone. It regulates our stress response through its two converters. The following terms from section 3 of Trauma Glossary 3 are covered in this article: Cortisol; Epinephrine; Norepinephrine. Due to the spelling similarities between epinephrine and norepinephrine, we will refer to Epinephrine by its other name, Adrenaline.
In the House of Stress: Boss Cortisol
It’s best to think of cortisol as boss of two opposite employees. First, there’s Epinephrine, whose office nickname is Adrenaline. This employee acts under pressure and makes split second decisions. Adrenaline is impulsive: act first and tell the boss about it later. Adrenaline is not a thinker. It’s an instinctual hormone that’s only concerned with fight or flight, but its energy tends to peter out just as quickly. Adrenaline’s fast actions can save them in a pinch, but it’s also been known to exaggerate threats (startle response). So, Boss Cortisol must swoop in constantly and review Adrenaline’s work.
Norepinephrine’s keyword is focused attention. It’s the thinker, slow to start but impossible to stop. So, Boss Cortisol, after reviewing Adrenaline’s work, calls on Norepinephrine to take over and get them to safety. Either course correct the mistake or provide the endurance to finish what Adrenaline started. Let’s see this in action from primitive to modern times:
Endurance to Finish
Primitive Man needs to escape the threat in the forest. Adrenaline releases first and tells him to run. The sudden release of blood flow to his vitals powers his speed to do so. He is running faster than he would in a calmer circumstance. Once he starts racing for his life, his cortisol releases. Cortisol wants to know only one thing: whether Adrenaline is overreacting. Seeing that the threat is still after him, Cortisol tells Adrenaline to keep going. Then Cortisol messages Norepinephrine, because Primitive Man needs more than to just run around aimlessly. Primitive Man needs to get to safety and that requires getting out of the forest. He needs his sense of direction to figure out how to do that.
Course Correct
Modern Man is switching lanes on the highway when the car next to him blares its horn. Realizing he’s in danger of causing a wreck, his adrenaline releases and tells him to move away from the threat. The good news is, he avoids hitting that car. The bad news is, he has swerved too far and almost collides with a car in the other lane. Cortisol releases and sees how Adrenaline is putting them even more at risk. Then it orders Norepinephrine to get in there quick. Norepinephrine ensures the car stays in its own lane, then checks and rechecks before switching lanes again. Speeding up or slowing down might be the only option for merging into the exit lane on time. Or, Modern Man will have to make do with taking the next exit, instead. It’s a minor inconvenience, but at least he will safely arrive at his destination.
Trauma’s small t’s vs. Big T’s: The Origin of Habits
When we’re experiencing a traumatic event, adrenaline releases and it triggers painful emotions. Then cortisol swoops in to see if there’s anything norepinephrine can do to solve our crisis. In both Primitive and Modern Man’s examples, they were adults who were free to act and move. As adults, they would also have the freedom to process or vent out the scary event right away. This would provide emotional relief and an appreciation for how they handled the crisis.
Children are powerless to Fight back or outrun (Flight response) the adult. So, norepinephrine directs its focused attention inward, either by dissociating (Freeze response) or absorbing the full blame (Fawn response) for what has happened. Their freedom to process the hurt into an improved perspective of the event is thwarted.
*Note, if you need a primer on the four trauma responses, a quick visual aid can be found here. It also includes a link to the article I wrote on the 4F Trauma Responses. Also, dissociation can be found in Trauma Glossary 2.
High Cortisol with Adrenaline: Big T’s Come with Big Emotions
How we feel about the memory determines whether it’s a Big T or small one. When we feel a high level of pain, it’s a Big T. EMDR specializes in the Big T’s because our emotions provide context for the thoughts and beliefs we developed from the event. It gives us the validation we need to process the event into full understanding. And from there, we lower our cortisol as we lower the emotional stranglehold. EMDR is a popular treatment for complex-PTSD but it isn’t our only option. The key to working through any Big T trauma is to process, process, process! The higher the emotional pain, the more the event needs processing.
This is what I always say in my group and I’m saying the same to you, dear reader. Keep venting it out. It doesn’t matter if you feel like you’re talking about the same thing over and over again with slightly different wording. Each time you process, you’re validating yourself while holding space for your emotions. This two-step process is the only path towards lowering the pain of a Big T.
Imbalanced Cortisol with Norepinephrine: small t’s Become Habit Forming
When the same type of trauma keeps occurring and we know that there is no escape, norepinephrine comes to our aid. As norepinephrine gave Primitive Man the endurance he needed to escape the forest, so it helps us endure the more frequent traumas. It does so by shrinking our emotional response to them. Because norepinephrine is a thinker, it supplies us with survival instructions as a means of protecting us from escalating abuse. Then it gives us the means of distracting ourselves from what we can’t control. This is how our coping mechanisms and our critic (Trauma Glossary 2) developed.
Norepinephrine gave us the tools to survive childhood adversity. Our coping mechanisms became our comfort zone, while our critic developed into our beliefs. The more negative cognitions (or beliefs) we have, the more we rely on our comfort zone. As we see it as our only source of safety, the world looks more threatening and we feel more powerless as a result. This becomes habit forming as it confirms and re-confirms our negative beliefs. Until we challenge our false beliefs, we will stay trapped in the loop of mere survival.
Cognitive Dissonance: The Challenge of Challenging Our Beliefs
We all have core beliefs. When we’re presented with a belief that contradicts one of our core beliefs, we experience cognitive dissonance (Trauma Glossary 1). We are confused and unsure of how to handle this new information. We may even want to accept the new belief but we struggle with digesting it. That’s because our active experiences created our core beliefs. Therefore, active experience with the new belief is the only way to change our core beliefs. As our core beliefs improve, so do our habits.
So, in summary, process the emotions and challenge the core beliefs we developed. Our thoughts and feelings are key to regulating our stress response. Boss Cortisol will thank us.
Further Reading
I wrote an article on the ways we can use the cognition sheet to change our negative beliefs into positive ones. It includes steps on how to use it and backed by my own experiences of how it helped me. You can find the article here. You may want to understand what our uncomfortable emotions are trying to tell us. This article uses 14 visual aids on understanding our emotional cognitions here.
In Trauma Glossary 3, section 2: Autonomic Nervous System (ANS), especially the Sympathetic nerve, which cortisol works with. Also in section 3: Serotonin because it’s a mood stabilizer and ideally, our goal is to create balance between cortisol and serotonin. Next week we will cover Dopamine and Norepinephrine will be returning with Boss Cortisol. Do you know why? Norepinephrine actually has two bosses, and dopamine happens to be its other one. But we will talk more about Dopamine and Cortisol’s joint custody battle then.