Abstract

Excerpted from The Biology of Trauma: How the Body Holds Fear, Pain, and Overwhelm, and How to Heal It by Aimie Apigian, MD ©2025 Aimie Apigian. Reprinted by permission of BenBella Books, Inc. All rights reserved.
The Fundamentals: Where to Start and Next Steps
The essential sequence and the Biology of Trauma framework may feel daunting to look at as a whole. Where do we even start? Which repair tools do we need, and in what order?
Wherever we are on our healing journey, there are fundamentals we can apply right now to help our body get unstuck. These fundamentals form the foundation of healing—without them, everything else we try will eventually crumble. Just as we can’t outrun poor nutrition or lack of sleep, we can’t “out therapy” these basic building blocks of recovery.
Let’s start with what our body needs most: rhythm and routine. Our nervous system thrives on predictability, which is why establishing daily schedules and routines is simple yet powerful. A consistent sleep, eating, and exercise schedule creates the predictability our body thrives on.
Creating a morning routine of hydration, movement, and natural sunlight helps reset our body’s natural cycles, allowing hormones like cortisol and melatonin to work optimally. When we follow these schedules daily, regardless of weekdays or weekends, our sleep quality improves. Better-quality sleep means our nervous system starts each day regulated and resourced. Establishing a bedtime routine and avoiding food for at least three hours before sleep provides essential support for our nervous system.
Dietary changes are another foundational piece. There are some nutrition fundamentals that increase our inner regulation and safety. Focus on whole foods over processed ones, eliminating harmful additives like high-fructose corn syrup and processed sugars and fats that cause inflammation and drain our energy. The specific diet that helps you feel most emotionally stable and healthy is often a good rule of thumb. Whether for you that is carnivore, keto, vegetarian, or vegan, the quality of ingredients and consistent meal timing will be a major support for your healing journey. Diet can be tricky, and on the resource website for my book (BiologyofTrauma.com/book), you will find trained health coaches available to help navigate our body’s unique needs.
Hydrate with water first thing in the morning before reaching for caffeine, so you don’t put the additional stress of dehydration on your body. We may find we want to avoid caffeine on an empty stomach, as it triggers higher adrenaline release. While the energy surge can help us feel focused and productive for a time, it can put us in an activation state that our body can’t maintain if it is struggling with mitochondrial compromise and energy depletion. It may be promoting our fatigue, freeze, and shutdown later in the day.
Another foundational daily practice is matching our activity level to our stress level, so we use up all the adrenaline we make. The amount of adrenaline we release each day, whether from caffeine, watching the news, or a full-on stress response, needs to equal our physical movement to prevent excess. Adrenaline that accumulates in our system will eventually become too much activation and push us over our critical line of overwhelm. It is often the consistent, regular activity that proves to be more effective than sporadic, intense workouts.
Throughout the day, take time to pause for body awareness and somatic self-practices. Create moments of felt safety and support. Notice when a part of you needs something and is trying to get your attention through your thoughts, body sensations, or emotions. These frequent pauses are how we rebuild the connection with ourselves and establish trust and communication with our own body.
Complete any startle and stress responses that your body initiates. For a startle, this means looking around at what startled you, even touching it if safe and letting out a sigh if that helps your body settle back down, signaling you are safe and can reset. Full stress responses take longer and are different, such as an acute stress like a near accident or a stress response stretching over a day or more. Completing a stress response requires a pause, giving our body the time to gather all the information it needs to truly know the danger is over. Sometimes, when completing one of these responses, our bodies will move involuntarily, such as trembling or shaking. When we allow that instead of blocking the reaction, the body will often complete its response without our direct control.
An example to illustrate this is when we have a near-miss accident on the road. Most people continue driving, but this prevents their body from completing the stress response, causing it to persist, and creating background stress over the course of the day. If this happens to you, instead, pull over safely and turn off the car. Let your body completely relax, taking your hands off the steering wheel and your foot off the brake. As we take in information by orienting ourselves to everything around us, feeling our body or parts of our car that tell us we are now safe, we will again notice our body settle back down with a deep sigh. We have just completed the stress response and can get back on the road, knowing our body has had the reset back to safety it needs.
Also, start shifting how you talk about yourself. Stop saying you’re broken, even in jest. Replace statements like “I am this way” or “This is just what I do” with past-tense language: “I have been this way” or “This is what I have done.” Even adding “Up until now” before these statements creates space for change. When we notice judgmental thoughts, use “parts” language, that is, “There’s a part of me that feels I can’t take breaks until everything is perfect,” rather than identifying fully with these beliefs.
Most importantly, we want to notice and stop ourselves when we start telling dramatic stories, whether of present drama or past events. Practice staying in the present moment with yourself and others. Ask: “What do I need right now to create an inner felt sense of safety and support?” This simple question can help us break free from old patterns of reaction and create new experiences of regulation.
For additional support on this journey, there are free guides and resources at BiologyofTrauma.com/book that expand on the science and applications we’ve explored. These resources can help us deepen our understanding and practice of these concepts.
Supporting Our Biology
While testing is helpful to be intentional about supplements we take, there are some fundamentals that are a safe place to start for most people.
Let’s begin with the basics. Magnesium, particularly in its glycinate form, acts as a natural support for our nervous system. When we’re stuck cycling between stress and shutdown, magnesium helps calm hyperexcitability while supporting cellular energy production. Many people find starting with 200–400 mg daily helps their nervous system find and maintain regulation more easily.
Vitamin C is another crucial antioxidant protectant, also helpful for reactions needed to generate a stress response. Many find 1,000 mg daily is enough to help support the immune and nervous system.
For those experiencing brain fog or persistent anxiety, two additional supports can be particularly helpful. NAC (N-acetylcysteine) helps calm brain inflammation that keeps us perceiving danger, while magnesium L-threonate is the form best known to specifically access and help neurons.
Many also benefit from gut–brain support through zinc carnosine and L-glutamine, as our digestive system becomes a major source of danger signals when compromised by chronic stress. However, remember to introduce supplements gradually, spacing them out by several days and paying attention to the body’s response.
The Journey Ahead
As we conclude this exploration of how our body experiences, holds, and heals trauma, remember that you’re not alone on this journey. We all have to lay the foundation of regulation, work through unconscious programming, and create the different experiences that would allow a better tomorrow.
The path forward isn’t about forcing change or pushing through barriers; it’s about creating new experiences that show our nervous system another way is possible. Whether you choose to focus on just the foundational practices or dive deeper into repair and expansion, know that each small step creates momentum for change.
Our body has been trying to protect us all along. Now we have the knowledge and tools to work with our body, rather than against it.▪
