It’s an interesting thing, trauma.
The “experts” define trauma in various ways, most commonly as something that changes the course of one’s life and is beyond their control, ultimately causing a sense of helpless and fear for one’s own life.
Those who have lived trauma might explain it a little bit differently. The experience of trauma is unique to every individual that has it. Some experience continued avoidance, hyperarousal, exaggerated startle response and intrusive memories. Some experience none of the above. Most fall somewhere between the two extremes.
Particularly in the recent past, with the #metoo movement and the number of women (and men) coming forward, it has been easy for people to say “But it happened so long ago” or “Why bring it up now?” or “Why does it matter? Can’t they just forget?” And the people saying those things don’t necessarily mean any harm; they just don’t know better.
There are some very specific reasons why trauma is a complex thing to “get over” and the problem is not that people are looking for attention, or playing the victim, or refusing to move on. Their brains have been changed. Fundamentally. In ways that can actually be seen on brain scans.
There are a lot of scientific words that could explain these phenomena, but I’ll try to simplify. Essentially, when a person has undergone trauma their brain is changed. Our brains change every day in response to the world around us and our experiences in it. People with trauma are no different. The problem is, trauma causes changes that tend to make every day life more difficult. There are three main structures that are changed: the hippocampus, the ventromedial prefrontal cortex, and the amygdala. There are also some neurotransmitters mixed in with those changes (namely cortisol and norepinephrine).
Basically, these changes cause a few things to happen. First, for a person with trauma, the brain is constantly on alert - perceiving even every day events as potentially dangerous. Its experience is that every day events HAVE been dangerous so why would things be any different now. Second, it becomes difficult for a traumatized brain to distinguish between past and present. Though the traumatic events have, objectively, happened in the past, the brain has a difficult time realizing that these memories are not current - thus, the subjective experience of ongoing trauma. Thirdly, the brain’s ability to moderate it’s emotional responses is changed. A brain that has experienced trauma has a hard time turning off the alarm bells that signal potential danger (and we’ve already discussed how the traumatized brain perceives danger everywhere). And finally, all that results in higher levels of chemicals in the body that suggest ongoing stress, and this can cause all kinds of medical things that are beyond the scope of this article.
Do you want the science? If yes, read on. If no (and my feelings won’t be hurt), skip this section and move to the next one. I’ll try to be brief. Here goes:
All of the following have been shown on MRI and PET scans of various brains (the control subjects being those without trauma and the test subjects being those who have experienced trauma). The amygdala is the part of the brain that controls emotions. It is right there in the center of the brain and is what causes you to feel sad, and scared, and happy, and alone. It sends out signals that cause the release of neurotransmitters and then you have emotion. For people who have experienced trauma, the amygdala works on overdrive. That area of the brain tends to show up brighter on PET scans as a result of greater activity. Control subjects have activity in their amygdalas as well (we all have emotions) but the activity is less intense and potentially less constant. The ventromedial prefrontal cortex is the part of the brain that tells the amygdala when to calm down. In animal studies, it has been shown that animals who have lived in high stress environments tend to have fewer neuronal branches in this part of the brain and therefore have a decreased ability to regulate the amygdala. The prefrontal cortex of people who have experienced trauma is smaller and therefore less effective at regulating the overactive amygdala. Finally, there is the hippocampus. This is also a central part of the brain and is where memories are stored and retrieved. In people who have experienced trauma, the brain actually has fewer cells in the hippocampus. This means that past, present and future are confused. At times, past memories or experiences can elicit responses just as strong as events that are happening in the present. The stress hormone that is released by the interaction of all these brain areas is cortisol. Cortisol is the body’s main stress hormone and can be found in greater amounts in the cerebrospinal fluid of people and animals who have experienced traumatic events.
Okay, so let me give you an example. There is a house fire. A child is in the house when the fire starts and witnesses his house burn down. The house is a complete loss, due to a faulty electrical switch. The child and his parents have to run to safety. He watches as the windows shatter and roof caves in. He smells the smoke and watches his parents cry. Finally the firemen come and put out the fire. Over time, the family rebuilds their home and life returns to “normal.” This child has experienced trauma. He emerged from the fire unhurt, but it was still traumatic. Now, let’s just say this same child has a parent that is not a very good cook. One day, this parent is in the kitchen baking cookies. Maybe the phone rings and she gets distracted for a couple of minutes or maybe she read the timing on the box incorrectly; but the cookies start to burn. The child is upstairs in his bedroom when he smells the smoke. Suddenly he panics, the last time he smelled smoke the house was on fire. He runs downstairs in tears and can’t control his breathing (perhaps he is having a panic attack). At this moment in time, his brain is reacting based on past events. It does not matter that the smell is from the burnt cookies and that the house and family are not in danger. All that matters is that that memory has been triggered. And the child’s brain has been changed so the part of the brain that would tell him to calm down is no longer as effective as if he had not had the trauma. While he could probably tell you that the fire happened in the past, it feels like it is happening then.
People with trauma will be triggered by events that you may not understand or recognize. People with complex trauma may not even be able to identify their own triggers. But when one of these triggers is touched (even slightly) the emotions spike because that part of the brain is on high alert. The emotions stay strong because the brain has a hard time sending a signal back to say there is no current danger. And then past memories are not “gotten over” because the parts of the brain that hold them are not adequately storing them and labeling them past; it is hard for new experiences to replace the expectations that old experiences will repeatedly happen and that danger will never stop.
So how can we say, “Why now? Why can’t they get over it? Why is it so important anyway?” It’s harder to say those things when we understand. The brain, when exposed to trauma, stops being exactly the same as a brain that has not been exposed. And these changes have a lasting impact on the life of the person - it’s not a matter of choosing to get over it, when the “it” has become brain based.
The good news is that research has also shown that the brain continues to grow and change over the lifespan (this is called neurogenesis). Even people who have experienced trauma are not doomed to deal with it forever - at least not at the same intensity or frequency. With new experiences that are not traumatic, the brain will start to encode new memories. New pathways will form that will be more adaptive and less reactive to triggers. The brain will learn that it does not need to expect danger at every turn. Antidepressant medication has also shown some promising results in enhancing brain growth, though that is an area that needs further research.
So in the end, there is hope for a different future. However, it’s never going to be a “just get through it” or “white-knuckle through.” Not when the actual physical structures of the brain are involved. That took time to change and will take time to repair.
Comments