According to Dr. Peter Levine, "the nervous system compensates for being in a state of self-perpetuating arousal by setting up a chain of adaptations that eventually bind and organize the energy into 'symptoms'. These adaptations function as a safety valve to the nervous system. The first symptoms of trauma usually appear shortly after the event that engendered them. Others will develop over time."
Following are groups of symptoms that tend to show up in the order listed. This is, however, a generalization. Symptoms in the second group may well show up in the first stages. Symptoms in the second group may also show up along with symptoms in the third group, etc. Some symptoms could well be included in all lists. There is no fixed rule that determines which symptom the organism will chose to enlists, or when it will chose to enlist it.
According to Dr. Levine, "not all of these symptoms are caused exclusively by trauma, nor has everyone who exhibits one or more of these symptoms been traumatized. The flu, for instance, can cause malaise and abdominal discomfort that is similar to trauma symptoms. However, there is a difference; symptoms produced by the flu generally go away in a few days. Those produced by trauma do not. The symptoms of trauma can be stable (ever-present), unstable (will come and go), or they can hide for decades. Generally, these symptoms do not occur individually, but in constellations."
Group I
- Hyperarousal
- Constriction
- Dissociations (including denial)
- Feelings of helplessness
Group II
- Hypervigilance (being "on guard" at all times)
- Intrusive imagery or flashbacks
- Extreme sensitivity to light and sound
- Hyperactivity
- Exaggerated emotional and startle response
- Nightmares and night terrors
- Abrupt mood swings (e.g., rage reactions or temper tantrums)
- Reduced ability to deal with stress (easily and frequently stressed out)
- Difficulty Sleeping
Group III
- Panic attacks, anxiety, and phobias
- Mental "blankness" or "spaciness"
- Exaggerated startle response
- Avoidance behavior (avoiding certain circumstances)
- Attraction to dangerous situations
- Frequent crying
- Exaggerated or diminished sexual activity
- Amnesia and forgetfulness
- Inability to love, nurture, or bond with others individuals
- Fear of dying, going crazy, or having a shortened life
Group IV
- Excessive shyness
- Muted or diminished emotional response
- Inability to make commitments
- Chronic fatigue or very low physical energy
- Immune system problems and certain endocrine problems such as thyroid dysfunction
- Psychosomatic illness, particularly headaches, neck and back problems, asthma, digestive issues, spastic colon, and sever premenstrual syndrome
- Feelings of detachment, alienation, and isolation - "living dead"
- Diminished interest in life
- Feelings and behaviors of helplessness
- Reduced ability to formulate plans