Neurobiology Of Trauma.
When an individual experiences intense psychological distress, the chemistry of the brain changes and it starts to function in a different manner. Such experiences give rise to emotions like severe anxiety, fear, horror and/or helplessness which can result in the development of trauma. Recent advances in technology have allowed experts to scan the brain circuits that manage anxiety and fear. They refer to the change in the frequency of the functioning of the brain as “Fear Circuitry”, which is a kind of a defense mechanism that is naturally present in humans. Anxiety disorders are a “whole brain” disorders which involve the complex interplay of neurons, more specifically they involve hyper-activation of brain areas that recognize and respond to threats. The amygdala, the insula, the dorsal anterior cingulate and the hippocampus are the areas of the brain which are concerned with conjuring fear and threat responses.
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Understanding the neurobiology of trauma is important as it helps in removing or breaking down common misconceptions about trauma and helps the survivors in understanding their experiences. Many people are aware or have heard about the concept of ‘flight’, ‘fight’ and ‘freeze’. The freeze response is commonly used as a reference to a deer when they stop dead when they see an approaching car’s headlights. Similarly, humans freeze when confronted with a traumatic experience or a stressful situation rather than fighting or running away. The hyper-activation of the amygdala (also known as the ‘center of emotions’), which is a structure in the midbrain that serves as a threat detector, puts into transit a biobehavioral response that enables a person to either fight or flee. This response involves rapid breathing, increased heart rate, sweating and other anatomical/physiological reactions which indicate the feeling of fear in an individual. Contrary to hyperactivation, the hypo-activation of amygdala is troublesome and dangerous as a person is unable to respond accordingly when under threat. Injury or harm to amygdala may result in an individual’s inability to experience fear.
Whereas the prefrontal cortex is the decision making part of the brain, the CEO, responsible for rational thinking, planning effective responses, and remembering important information. Simply put, the prefrontal cortex is the executive functioning center of the brain. Here, the information is first processed before being relayed to the amygdala. It is a slower process which allows time for a more thorough analysis of a situation, administering an overactive amygdala which results in a more modulated and nuanced response depending on the level of the threat. However, when a person is experiencing a traumatic situation, the brain switches to survival mode, meaning the prefrontal cortex may start to function less effectively and the individual may not be able to think through the situation to make essential decisions.
Apart from the prefrontal cortex and amygdala, the hippocampus plays a role in moderating stress and fear. This area of the brain is responsible for cognition, learning, perception and resurgence of memory. For instance, an individual can be triggered if their surrounding environment bears resemblance to the place or situation where the instance occurred. This is due to the hippocampus which helps in separating the present experiences from the past. A hormone called ‘cortisol’ is released by hippocampus which helps in regulating stress response. But if there are higher levels of cortisol released then the hippocampus reduces in size which results in difficulty while trying to recall past events.
Trauma survivors may also experience dissociation. This is a form of survival mechanism where an individual might feel disconnected from their body or may go into auto-pilot mode. An individual may behave based on habitual modes of being, actions which have been socially conditioned, where the prefrontal cortex is not used to make decisions. For instance, women are conditioned to behave in a ‘polite’ and ‘pleasing’ manner, so if they feel uncomfortable by a male figure, their instinctive or conditioned response is to act polite and smile, even if they are experiencing extreme fear. Acting politely and smiling to get out of a stressful and uncomfortable situation has been a survival mechanism for women where their brain is operating on auto-pilot.
The brain and nervous system are made of billions of neurons, interconnected to form a neural network. Neurons communicate with each other and get wired together when they do, resulting in the “wiring” of the brain. Changes in this wiring of the brain circuit can occur anytime during an individual’s life. So, if a person experiences single or repeated traumatic experiences, their neural network gets “re-wired”. Gaining an understanding about the neuroscience/neurobiology of trauma, how traumatic event(s) affect a person’s brain, is helpful, not only for the individuals with traumatic experiences but also provides helpful information for those who might know someone living with traumatic experiences. There are many different methods and strategies one can take to reduce or overcome traumatic symptoms, some of them include:
Cognitive Processing Therapy (CPT): It is a specific form of cognitive behavioral therapy which takes place over a course of 12 sessions where a person with trauma symptoms is shown how to evaluate and change upsetting thoughts. By changing the thoughts one can change how they feel.
Prolonged Exposure Therapy (PE): Exposure therapy is another form of psychotherapy where an individual is helped gradually to reconnect with their life and things they have been avoiding, so that they can strengthen their ability to differentiate safety from danger.
Pharmacotherapy or Drug Therapy: Pharmacotherapy is a medication based therapy that helps in reducing the intensity of withdrawal symptoms and/or cravings for alcohol or other drugs. It is often used together with other therapies such as CPT.
Stress Inoculation Therapy: SIT is another form of Cognitive Behavioral Therapy where an individual undergoes training to help them quickly defend against trauma related fear and anxiety when exposed to reminders which may trigger them.
Although trauma symptoms can be managed, mental health professionals are hesitant to say that they can be cured as there is always a chance that formerly experienced symptoms may return. However, it is imperative for individuals suffering from trauma symptoms to understand that recovery is possible and that we are here to help. At Pause for Perspective we have trained therapists who are ready to help you through your tough times. We believe that everyone deserves to feel safe in their own body and mind. They deserved to be reached out to and show that their trauma does not have to dictate or control their life.
Below is a list for the articles based on trauma:
Written by Insha Fatima
Writer at Pause for Perspective.