This page has some snippets of research on the brain and trauma. It was only 20 years ago that scientific researches discovered our brains have neuroplasticity. Our brains develop throughout our whole lifetime and based on our experiences, new neural pathways develop.
Watch this clip from my interview with Dr Rick Hanson on improving our brain
3 Brain Changes with PTSD
From trauma specialist Dr Bessel van der Kolk, MD
1: Threat perception system is enhanced. Traumatized people see danger where other people see manageable stuff. This is in the core perceptual, primitive part of the brain.
2: The filtering system higher up in the brain that helps to decipher what is relevant right now is messed up. This leads to trouble focusing and difficulty fully engaging.
3: The self-sensing system, which runs through midline structures of the brain and is devoted to your experience of yourself, is blunted. It is a defensive response. When you’re in a state of terror, you feel it in your body, in terms of heartache and gut wrenching feelings. Your body feels bad. Some people start taking drugs to dampen this and others find a way of naturally dampening the internal response to yourself. The trouble is that is also dampens the response to pleasure, sensuality and connection.
Trauma impairs integrative functioning in the brain. Brain functioning will become inflexible, maladaptive and incoherent. Instead of being energized, it could be depleted or excessively aroused – not functioning with an optimal amount of energy. In terms of stability, it can have a strange instability and may repeat patterns that are recurrently dysfunctional. From the outside it looks stable, but the “stability” is recurrent dysfunction.
Impact of trauma on social interaction:
- With early life trauma, the brain network that allows us to interact socially doesn’t develop fully. We often have difficulty making eye contact, trusting and getting close to others, which are keys to having a good quality of life.
- Trauma disrupts the connection between the brain and body. It impairs our ability to read social cues from facial expressions. We can’t tell if a situation is safe or not so we may over-protect.
- Connection with other people is essential to help regulate our system. We have a biological imperative to connect with other human beings.
- Trouble with interpersonal relationships is a result of self-protective emotional shutdown and is a subset of a larger human tendency to avoid painful experiences. Trauma shuts us off from being with other people.
Brain’s response to trauma
When a person experiences a traumatic event, the primitive or reptilian brain goes on red alert. See below to understand why working at a deeper level than the conscious part of the mind can be a powerful tool in dealing with PTSD.
People with PTSD commonly feel disconnected and numb. Yoga and breathing practices can help you feel more connected to yourself and others and to feel more positive. In addition to talking and other therapies, we need to create conditions whereby the primitive brain heals and comes out of the state of red alert. People with PTSD can be stuck in a hyper-vigilance response cycle. Yoga therapy that works below the level of the thoughts in the mind can help to heal this pattern.
The following is a basic explanation of brain anatomy and function from McGill University and the Canadian Institute of Health Research and Canadian Institute of Neurosciences, Mental Health and Addiction.
Your amygdalae are essential to your ability to feel certain emotions and to perceive them in other people. This includes fear and the many changes that it causes in the body. If you are being followed at night by a suspect-looking individual and your heart is pounding, chances are that your amygdalae are very active!
In certain studies, researchers have directly stimulated the amygdalae of patients who were undergoing brain surgery, and asked them to report their impressions. The subjective experience that these patients reported most often was one of imminent danger and fear. In studies of the very small number of patients who have had had only their amygdala destroyed (as the result of a stroke, for example), they recognized the facial expressions of every emotion except fear.
In fact, the amygdala seems to modulate all of our reactions to events that are very important for our survival. Events that warn us of imminent danger are therefore very important stimuli for the amygdala, but so are events that signal the presence of food, sexual partners, rivals, children in distress, and so on.
Two Pathways of Fear:
The amygdala lets us react almost instantaneously to the presence of a danger. So rapidly that often we startle first, and realize only afterward what it was that frightened us. How is this possible?
It all has to start, of course, with a sensory stimulus, such as a strange shape or a menacing sound. Like all information captured by the senses, this message must be routed first to the thalamus. The thalamus then sends this message on to the appropriate sensory cortex (visual cortex, auditory cortex, etc.), which evaluates it and assigns it a meaning. If this meaning is threatening, then the amygdala is informed and produces the appropriate emotional responses.
But what has been discovered much more recently is that a part of the message received by the thalamus is transferred directly to the amygdala, without even passing through the cortex! It is this second route, much shorter and therefore much faster, that explains the rapid reaction of our natural alarm system.
Since everything has a price, this route that short-circuits the cortex provides only a crude discrimination of potentially threatening objects. It is the cortex that provides the confirmation, a few fractions of a second later, as to whether a given object actually represents a danger. Those fractions of a second could be fatal if we had not already begun to react to the danger. And if the cortex turns out to advise us that there is nothing to worry about after all, we have merely had a good scare, and that is it.
John Hopkins University research findings into how what is going on in your gut can affect your brain.
Yogis have been studying the mind and brain for 5,000 years and have effective practices to heal the brain, anxiety, depression and PTSD. An example is Western medical science recent discovery and documenting of the vagus nerve and polyvagal system. It is an exciting time in brain research.
“The whole of the mind is not in the body, but the whole of the body is in the mind.” Swami Rama of the Himalayas
PTSD, Interoception and Affect Regulation
Dr van der Kolk from 2014 NICABM series
Flashbacks: When people start reliving their trauma, much of their brain goes offline. They immediately get pulled back into the past. Their emotional brain on the right goes back there, sees the images of what happened back then, and experiences physical sensations. Stress hormones get released and the body starts behaving again as if the trauma is happening right now. The timekeeping part of the brain that tells you, that was then and this is now, tends to go offline. When you really go into the most elementary, fear-driven situation, you cannot talk.
We help people to integrate the story and it becomes a memory of the past. We do this by focusing on being very present in the here and now at any moment. You do that with breathing, tapping, eye contact, feeling your body – keeping your interoception aligned.
A big job of being a therapist for traumatized people is to be an affect regulator who keeps their body safe and makes it safe for the mind to visit the past without getting hijacked by it.
Neurobiology: what happens in the brain
- The amygdala, the part of the primitive brain area that makes you afraid, becomes hyperactive and the threat perception system is enhanced. Traumatized people see danger where other people see manageable stuff. This is in the core perceptual, primitive part of the brain.
- The filtering system higher up in the brain that helps to decipher what is relevant right now is messed up. This leads to trouble focusing and difficulty fully engaging. The thalamus receives sensory input and, when in a very high state of arousal, breaks down into unintegrated images, sensations, thoughts, smells and sounds of the trauma. Trauma is about sounds and images that make you flash back. This happens because the thalamus can’t do its job.
- The self-sensing system, which runs through mid line structures of the brain and is devoted to your experience of yourself, is blunted. It is a defensive response. When you’re in a state of terror, you feel it in your body, in terms of heartache and gut wrenching feelings. The body feels bad and we often seek to escape through addictions and compulsions.
- The medial prefrontal self-experience part of the brain determines how reactive you are to your environment. The more trauma you have, the more reactive you are.
- Flashbacks: When people start reliving their trauma, much of their brain goes offline and they immediately get pulled back into the past. We may see images and experience physical sensations. Stress hormones get released and the body starts behaving again as if the trauma is happening right now. The timekeeping part of the brain that knows “that was then and this is now” tends to go offline.
Dissociation can be helped when we learn to notice what triggers it. Develop awareness of the first thing you experience as it starts to happen so you can implement your strategies for staying present.
How trauma hijacks the brain
The amygdala, the part of the primitive brain area that makes you afraid, becomes hyperactive. How do you rewire it? We don’t completely know that yet. We do know you cannot change irrational, organic responses from your body, except by becoming deeply involved in your self – noticing your internal world.
The thalamus receives sensory input and, when in a very high state of arousal, breaks down into unintegrated images, sensations, thoughts, smells and sounds of the trauma. Trauma is about sounds and images that make you flash back. This happens because the thalamus can’t do its job. How to calm the thalamus? Neurofeedback helps. EMDR is being studied now for this and initial research backs up it’s effectiveness.
The medial prefrontal self-experience part of the brain determines how reactive you are to your environment. The more trauma you have, the more reactive you are. The good news is the neuroplasticity of the brain. The more you experience your internal world, the more you build up and activate this part of your brain safely, you then experience less reactivity.
Yoga, meditation and mindfulness help. You see things happen and do not automatically react to them. You learn to be still, to notice your self, and to tolerate your sensations.
Symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you may have PTSD.
Common symptoms of PTSD
- Reliving the event (also called re-experiencing symptoms)
- You may have bad memories or nightmares. You even may feel like you’re going through the event again. This is called a flashback.
- Avoiding situations that remind you of the event
- You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
- Feeling numb
- You may find it hard to express your feelings. Or, you may not be interested in activities you used to enjoy. This is another way to avoid memories.
- Feeling keyed up (also called hyperarousal)
- You may be jittery, or always alert and on the lookout for danger. This is known as hyperarousal.
People with PTSD may also have other problems. These include:
- Feelings of hopelessness, shame or despair
- Depression or anxiety
- Drinking or drug problems
- Physical symptoms or chronic pain
- Employment problems
- Relationship problems, including divorce
In many cases, treatments for PTSD will also help these other problems, because they are often related. The coping skills you learn in treatment can work for PTSD and these related problems.
Changes in Trauma Treatment
From Dr Ruth Buczynski, NICABM:
We think in terms of three parts of the brain, the pre-frontal cortex, the limbic brain and the lower, more primitive brain. And we’re much more sophisticated in thinking about which part needs our intervention.
We understand that the lower brain can command the shutdown response, totally bypassing the prefrontal cortex, totally bypassing any sense of “choice” for the patient.
As someone who’s been practicing for a while, I’ve seen our view on the treatment of trauma go through substantial development. Our research, theory and treatments have all advanced considerably in the last 40 years. And as I reflect upon this, I’m seeing 3 waves in the evolution of our outlook. Looking back at when I first began to practice (in the late 70’s) our understanding of trauma was really quite limited. Of course we recognized the fight / flight response ever since Hans Selye introduced the notion back in the 50’s. But our prevailing treatment option was talk therapy. The thinking at the time was that by getting clients to talk about their traumatic event, we could “get to the bottom of” their issues and help them heal.
We were aware of the body and knew it held some power. But few practitioners used it in treatment (except the relatively few who worked with Bioenergetics, Rolfing, Feldenkrais, Rubenfeld, and to some extent Gestalt therapy). But we were very limited in our ability to explain how body work, or for that matter, a talking treatment, affected the brain (and we had very little evidence-based research for it either). We just didn’t have much of a roadmap to guide us where we wanted to go. That was the first wave.
Over time, researchers and clinicians started to recognize the limits of talk therapy. We realized that talking about a traumatic event held certain risks. At times, we inadvertently re-traumatized patients, especially if interventions were introduced too soon, before the patient was ready. We also saw the memory of trauma as more often held in the right brain, the part that doesn’t really think in words. So we began to use interventions that weren’t as dependent upon talking, interventions like guided imagery, hypnosis, EMDR, and the various forms of tapping. And as the science surrounding the brain’s reactions to trauma became more sophisticated, clinicians grew to understand more about what was going on. We began to realize that not everyone who experiences a traumatic event gets PTSD. In fact, most people who experience a traumatic event don’t get PTSD.
And so researchers started to develop studies to determine who did and who didn’t get PTSD. We looked for what factors might predict greater sensitivity to trauma. And we modified our thinking to add freeze (later known as feigned death) to the fight/flight reaction. Just adding that piece clarified our thinking about what triggers PTSD. It also began to expand our treatment options to include sensory motor approaches. And we started to see how more vastly intricate and multifaceted multiple trauma was compared to single incident trauma.
But I believe a third wave of trauma research and treatment innovations has just begun to crest. And it’s only come recently.
In just the past year and a half, pioneers in the field of trauma therapy have once again discovered more effective methods for working with trauma patients. Because of all the research that’s been done, we are much better able to predict who gets PTSD and who doesn’t. Not only that but we’ve got a good handle on why certain people get PTSD. And as brain science has revealed how different areas of the brain and nervous system respond to traumatic events, we don’t think so often about whether trauma is stored in the left vs right brain.
We think in terms of three parts of the brain, the pre-frontal cortex, the limbic brain and the lower, more primitive brain. And we’re much more sophisticated in thinking about which part needs our intervention. We understand that the lower brain can command the shutdown response, totally bypassing the prefrontal cortex, totally bypassing any sense of “choice” for the patient. And we see more clearly the part that the vagal system plays in this shutdown response. We understand more of the role neuroception plays in feeling safe.
Knowing how the body and brain react to trauma opens the door for the third wave. We are now beginning to use techniques like neurofeedback (based upon but a long way from the biofeedback we used years ago,) limbic system therapy, and other brain and body-oriented approaches that include a polyvagal perspective. These are techniques I couldn’t have dreamed of when I began clinical practice, and for the most part, they weren’t prevalent five years or even two years ago. But these are powerful tools that can offer hope to those who have been stuck in cycles of reactivity, shame, and hopelessness.
How Traumatic Memory Is Different from Everyday Memory
“Instead of forming specific memories of the full event, people who have been traumatized remember images, sights, sounds, and physical sensations without much context.”
“The brain continually forms maps of the world – maps of what is safe and what is dangerous.”
That’s how the brain becomes wired. People carry an internal map of who they are in relationship to the world. That becomes their memory system, but it’s not a known memory system like that of verbal memories. It’s an implicit memory system.
“It’s important to recognize that PTSD is not about the past. It’s about a body that continues to behave and organize itself as if the experience is happening right now.”
When we’re working with people who have been traumatized, it’s crucial to help them learn how to field the present as it is and to tolerate whatever goes on. The past is only relevant in as far as it stirs up current sensations, feelings, emotions and thoughts.
Trauma changes people. They feel different and experience certain sensations differently.
Some of the best therapy is very largely non-verbal, where the main task of the therapist is to help people to feel what they feel – to notice what they notice, to see how things flow within themselves, and to reestablish their sense of time inside.
All too often, when people feel traumatized, their bodies can feel like they’re under threat even if it’s a beautiful day and they’re in no particular danger.
So our task becomes helping people to feel those feelings of threat, and to just notice how the feelings go away as time goes on. The body never stays the same because the body is always in a state of flux.
The National Institute for the Clinical Application of Behavioral Medicine (NICABM) has many excellent resources. Click here for full report on NICABM