Some people who have been subjected to traumatic experiences engage in repetitive self-destructive behaviours including the abuse of drugs, and suffer from fears that interfere with everyday functioning at work and at home. On the other hand, the majority of people who undergo trauma are not severely affected over the long term by these experiences, and this often leads to judgment and misunderstanding of those who are more affected. Psychological research has begun to clarify what happens in the brain and body when someone is overwhelmed and the protective factors that can prevent long-term disturbance.
What is Trauma?
A traumatic experience is one that is overwhelming emotionally, cognitively and/or physically, often accompanied by feelings of extreme terror and helplessness. Numbing of emotion is a common response. Trauma can be acute or chronic, first-person or vicarious.
A traumatic experience is an extraordinary experience that shakes one’s sense of safety and security, and activates the most primitive part of our brain. Senses perceive danger, hypervigilance increases, blood rushes to the extremities, and access to complex reasoning is restricted. These responses are normal in the days and weeks following a traumatic experience, but when severe disturbance continues beyond a few weeks or months it can become disabling, resulting in a diagnosis of Post Traumatic Stress Disorder, or one of the anxiety-related diagnostic categories (DSM-IV).
Primitive Instincts, Complex Brain
Fight, flee, or freeze are instantaneous reactions that leave no time for reflection or analysis. These are life-saving and essential instinctive reactions in a crisis, but these same forces can result in tragic violence and self-destructive behaviour if the stimulus is actually benign. In a continuous state of fear or anxiety, traumatized people often resort to self-medication with alcohol, illegally obtained prescription drugs, or street drugs. Violence often results also, as survivors lash out at perceived danger.
The extraordinary nature of traumatic events means that incoming sensory data does not fit into the individual’s conceptualization of the world, people, and most importantly her/himself. Imagine a cursor wandering through various folders and files desperately trying to find someplace to store this new data. When this attempt at filing away an experience is incomplete, the memory continues to feel current, leaving the individual in a state of hyper-vigilance and chronic fear. This results in both emotional, and sometimes physical, pain for the traumatized individual.
We are complex beings with the ability to reason in an abstract manner, so as our primitive brain is automatically processing an experience, the more complex, highly developed part of our brain searches for meaning, asking questions such as: what does this mean in terms of who I am, my self-worth, my potential for safety, security, and contentment?
Normal Response to Extraordinary Experience
When we perceive danger, a normal adaptive response is to fight, flee, or freeze. If we are overpowered by someone or something, and physical escape is impossible, our brain/body is able to suspend conscious awareness of physical and emotional pain. This can make the memory of the event inaccessible briefly or even for a long time. This is an amazing neurological response that is an attempt to compensate for the inability to escape, but this emergency response can become maladaptive over the long-term, and can interfere with sensory awareness in a non-emergency situation.
Typical and normal short-term effects from a traumatic experience might include emotional ups and downs, an increased sense of danger and insecurity, physical symptoms including shakiness, nausea and sleep disruption. Normally, with appropriate support, these effects settle down and a sense of efficacy and resilience returns. Nightmares stop as the information has been integrated into appropriate files, or a new folder is opened and the person’s self-concept and life-view is altered, as with any new awareness. There is an awareness of the traumatic memory becoming less distinct and less disturbing.
Failure of Integration, Increased Vulnerability
When integration of an experience has been incomplete, reminders, even subconscious reminders of that experience, can activate the sub-cortical neurobiological processes responsible for attention, memory, and emotional arousal. Neuropsychologists such as Bessel Van Der Kolk at the Trauma Center in Boston have conducted research that explains how the emotional part of the brain dominates the rational, language processing part of the brain in times of extreme stress, impacting the ability to modulate emotional and physiological arousal. This can result in apparently irrational, dangerous behaviour which, ironically, increases the danger of further traumatization. As Dr. Van Der Kolk expresses it, “traumatized individuals lose their way in the world”.
Increased vulnerability is, in part, due to negative, self-referencing beliefs resulting from early and often chronic trauma. These irrational beliefs (e.g. I’m dirty, I deserved it, I’m not worth loving, I’m disgusting, I’m dying, I’ll never be safe) reside at a deep level but have a destructive effect on self-concept and resilience, inhibiting growth and influencing decision-making. Repetitive reenactment and reliving of the trauma, substance abuse and self-harm are evidence of the limitations on conscious control of emotions and behaviour when old trauma is reactivated.
Seemingly irrational behaviour has an adaptive purpose to the traumatized person, whether the person is able to articulate the purpose or not. Substance abuse is an attempt to feel better in some way; lashing out in anger can serve a protective purpose, and even self-harm has meaning to the individual. These and other attempted adaptations are less than ideal, but with insight and relief from chronic terror healthier adaptive strategies can be mastered.
Recovery depends on the survivor attaining safety, building a support network, learning skills for self-soothing and protection, and developing a realistic and compassionate self-concept.
What Influences Resilience?
Human children, unlike most animals, are dependent on adults for safety and security for many years while they develop the ability to manage their behaviour and emotions independently. This gradual progression from external to internal locus of control requires a balance of safe and predictable boundaries and healthy, consistent attachment with caregivers. Bruce Perry, M.D., PhD., uses the term “somatosensory bath” to describe the experience of a developing child, ideally enveloped in verbal and non-verbal expressions of compassion and care.
Resilience, or the ability to rebound from life’s stressors, varies among individuals. Inborn temperment and prenatal influences have some influence, but caregivers during early childhood have the greatest impact. Healthy attachment relationships provide the best foundation for recovery from traumatic stress, including immediate family, social and community/spiritual/cultural supports.
Families and communities that provide safety and security, adequate sustenance and strong role models, have clear and consistent boundaries, and communicate to the child that they have worth, will produce children with optimum resilience to traumatic stress. A child’s ability to learn from his or her experiences, leading to a sense of efficacy, is enhanced when caregivers provide logical and natural consequences and educational discipline rather than harsh punishment, which is traumatizing. Resilient children grow into adults that are resilient and caring caregivers.
Bessel Van Der Kolk, PhD. Clinical Implications of Neuroscience Research in PTSD. Annals. N.Y. Acad. Sci. xxxx: 1–17 (2006).
Bruce D. Perry MD, PhD. Resilience: Where Does It Come From? Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine; and Chief of Psychiatry, Texas Children’s Hospital, Houston, Texas. April 2006.
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