A few days ago, I was speaking with a high-achieving, articulate, brilliant friend, someone always up and doing, super-expressive. During our conversation, I noticed her stumbling over her words, which was quite unusual, and her fidgety hands. She was narrating a traumatic incident that had occurred to her and how it tore her apart and made her simply give up on everything, in her words, “she was done.” Throughout the conversation, I held her hand and told her to express anything else that might be troubling her, and she narrated so many more events, which were equally as bad, and even worse, than the final event that was the straw that broke the camel’s back. We laid out all the risks associated with giving up, all the promises she had made to herself about becoming a rockstar, but in that moment, she couldn’t see any of that. Nothing had meaning. Life would begin to rewrite itself based on what’s happening inside of her, based on pain, based on how she feels; it’s a torture that is inexplicable for anyone who hasn’t held such fire within them. The conversation took me back to my knowledge on trauma, especially the excerpt from Gabor Maté: “Trauma is not what happens to you but what happens inside you.” For many high-functioning people, that inner injury is invisible. They keep performing, keep showing up, while their nervous system is quietly burning.

People like her show up everywhere, in medicine, tech, academia, caregiving, and entrepreneurship. They are the residents who always pick up the extra shift, the founders who keep pushing through “one more milestone,” the family members everyone leans on. They know how to function. We begin to wonder how a brilliant teammate like my friend, working in a fast-paced corporate culture, starts obsessively checking emails, constantly worrying she’s never enough, working harder, and living in perpetual fear of being reprimanded or terminated. For others, it’s a body that keeps screaming through migraines, gut issues, chest tightness, or unexplained pain while every lab and scan comes back “normal.”

Trauma can significantly change the adult brain, especially in regions involved in emotion, memory, and decision-making. The amygdala, the alarm system, can become overactive, keeping a person in a constant state of alert. The hippocampus, which helps us form coherent memories and regulate stress, may shrink in people with chronic trauma, contributing to intrusive memories or flashbacks. The prefrontal cortex, which supports planning and impulse control, can become less effective at applying the brakes. Together, these changes keep the nervous system in a state of survival, so fight-or-flight or freeze reactions are triggered by situations that only vaguely resemble the original threat.

The current clinical framework for trauma leans heavily on tools like the DSM-5, which was designed as a manual for classification rather than a roadmap for healing. It helps clinicians identify disorders based on symptom clusters, often through forms completed in the waiting room or between sessions. That can be useful for diagnosis, but it doesn’t necessarily reveal what is happening underneath. Patients living with profound distortions may not be able to recognize or name their experience on a checklist, and intellectualizers or those with a strong, defended self-image often “tick positive” no matter what; for example, someone who dissociates regularly is unlikely to label it that way. The same limitation shows up in tools like the PHQ-9: they were developed to mirror DSM criteria and are excellent for screening, but they were never meant to explain why someone is suffering or how to heal the injury underneath. This is why we now need complementary tools, not only to diagnose but also to track and support what is actually happening inside a person over time.

Treating conversation like brain activity

Neuroscience has spent decades asking how to find meaning in noisy neural signals. Neurons don’t fire messages labeled “this is fear” or “this is memory.” They produce spike trains, bursts of activity that only make sense when you study their patterns over time. Human conversation isn’t so different. We rarely say “I am traumatized” directly. Instead, we leave signals: shifts in pace, emotional tone, response delays, and the move from engagement to withdrawal. These are conversational spike trains; messy on the surface, but highly informative when processed well.

In my work, this led to a neuroscience-inspired framework for conversation signal processing: treating dialogue less like static text and more like brain activity unfolding in time. One element is evidence-normalized rate coding. Instead of simply counting how many “negative” words a person uses, we look at the rate of distress signals relative to their usual speaking style. That helps us see how suffering accumulates over time. A highly articulate person may say more overall, but when you normalize their style, you can see whether distress is actually rising or falling.

We also apply temporal filtering, tracking how patterns evolve across multiple conversations rather than relying on a single snapshot, such as “the last two weeks.” Declining participation, persistent negative affect, or growing isolation language are not necessarily signs of imminent crisis, but they are early warning signals of sustained decline. Finally, pace-independent metrics decouple the signal (suffering) from the medium (eloquence or fragmentation). A quiet person and a talkative colleague can be compared more fairly, and both can be seen more accurately, long before they reach a breaking point.

Moving from labeling to healing

By quantifying these invisible dynamics through AI grounded in neuroscience, we can do what traditional tools cannot: detect suffering in high-functioning individuals who have learned to mask their pain, track trajectories rather than just states, and support clinical judgment with precise temporal patterns rather than one-off scores. The goal is not to replace clinicians, but to give them better instruments for seeing what has always been there.

That day, holding my friend’s hand, I couldn’t see her amygdala or hippocampus. But I could see the signals in how she spoke, paused, and struggled to stay present. The framework we’ve built doesn’t replace that human moment but scales it. It creates the possibility that every conversation could be heard with the same attention, that people suffering invisibly could be noticed before they reach the point of being “done.” Because trauma is what happens inside you, and for the first time, we are beginning to build tools sophisticated enough to witness it.

Ronke Lawal is the founder of Wolfe, a neuroadaptive AI platform engineering resilience at the synaptic level. From Bain & Company’s social impact and private equity practices to leading finance at tech startups, her three-year journey revealed a $20 billion blind spot in digital mental health: cultural incompetence at scale. Now both building and coding Wolfe’s AI architecture, Ronke combines her business acumen with self-taught engineering skills to tackle what she calls “algorithmic malpractice” in mental health care. Her work focuses on computational neuroscience applications that predict crises seventy-two hours before symptoms emerge and reverse trauma through precision-timed interventions. Currently an MBA candidate at the University of Notre Dame’s Mendoza College of Business, Ronke writes on AI, neuroscience, and health care equity. Her insights on cultural intelligence in digital health have been featured in KevinMD and discussed on major health care platforms. Connect with her on LinkedIn. Her most recent publication is “The End of the Unmeasured Mind: How AI-Driven Outcome Tracking is Eradicating the Data Desert in Mental Healthcare.”