It is common knowledge that past traumas change people. It is well known that trauma increases the chance of anxiety and depression, and disrupts functioning in a number of ways. But it may not be so common to think about how this change happens. It is through changes in our brain that trauma disrupts our thought patterns, emotions and behaviors. Recent research has dug deep to understand the details of these changes and what needs to be done to heal the brain so that we can experience less disruptive symptoms. According to researcher Jennifer Sweeton PsyD, M.S., M.A., (www.jennifersweeton.com) the goal of therapy is to change the brain.
There are several areas of the brain that become overactive or underactive because of traumatic experiences. These are then manifested in disruptive symptoms. The primary area that becomes overactive is the amygdala. It is the ‘smoke alarm’ of the brain. It asks, ‘Is this dangerous?’ Working with the memory center, it determines if something is dangerous and begins the stress response, which can be experienced as anxiety, or any of many physical symptoms. It also suppresses the higher thinking. When someone has repeated dangerous events the amygdala can become overactive and hypersensitive, resulting in an overreaction to even small events that would not normally be considered dangerous. When the amygdala completely hijacks the rational thinking it can cause a blackout or amnesia.
To heal from trauma the amygdala needs to be calmed and relearn what is truly dangerous, and what is not. This can be done within a safe therapeutic setting where the person learns to turn off the danger signals and can think through triggers that had set them off, to relearn that they are not really a threat.
There are several areas of the brain that become underactive due to repeated trauma. The hippocampus is one of these areas. It is the storage area for autobiographical memory. It is the memory center that the amygdala works with to decide what is dangerous. With repeated trauma there can be atrophy in the hippocampus, which can cause memory problems. People can help the hippocampus to stop sending danger signals by working with memories that used to feel dangerous, learning that they are not dangerous. Bringing the memory up in a safe environment, and doing something with it, like telling the story, can reduce the sense of danger, because every time we remember something we remember the last time we remembered it, not the original, so we are reconsolidating each time. The hippocampus can also be strengthened with physical exercise, Omega 3 and meditation.
Another area of the brain that is underactive after repeated trauma is the insula. The insula is the part of the brain involved in awareness of the body and internal states including emotions. During trauma people learn to turn this awareness down or off as a way to protect themselves from the pain, either physical, sexual or emotional. Turning it down can become a habit resulting in the feeling of numbness or, when turned off completely, can cause dissociation. Spikes in insula functioning can create flashbacks. This area of the brain needs to be on for healing to happen. Low insula functioning is the main reason attempts at therapeutic change fails, according to Dr. Sweeton. Use of sensory awareness exercises like movement, stimulation and mindfulness exercises can improve insula functioning.
Two more areas that are underactive after repeated trauma are the cingulate cortex and the prefrontal cortex. The cingulate cortex is involved in emotional regulation and decision making. The prefrontal cortex is the center for rational thoughts, goal-making and decision-making. When the amygdala senses danger it deactivates both of these areas. When the amygdala is over sensitized and habitually turned on, then both of these decision making areas are chronically turned off. They need to be activated to make good decisions. They can be strengthened with cognitive work, like talk therapy, once the insula has been activated and the amygdala has been calmed in a safe environment.
It is more clear than ever that trauma in a person’s past has real changes in their functioning based on the direct effect of the trauma on the brain. It is also clear that there are many positive and effective treatments that can improve a person’s life and functioning. These therapeutic interventions are generally done within the support of individual therapy. Some people have found self-help tools that address many of these symptoms. For those who need more support than either of these approaches MidMichigan Health provides a Partial Hospitalization Program at MidMichigan Medical Center – Gratiot. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit www.midmichigan.org/mentalhealth.