Tuesday, March 28, 2017

More brain and trauma stuff

I just finished reading The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk. Boy, talk about a fascinating book. I might actually break down and buy myself a copy just to have as a reference.

Perhaps one of the most difficult things for people to wrap their heads around is how systemic the affects of trauma can be. Even for those of us who live with people affected by trauma, we can sometimes forget or not understand what is really going on inside our child. From the outside looking in, it seems like a simple problem. Yes, what you experienced in the past was horrible and rotten. But now you are in a good place, with people who love and care about you and will be sure that your needs are met. You are now safe and secure. That should do it, let's move on. It can feel frustrating when the person affected by trauma doesn't seem to want to get on that particular train.

What recent brain science is learning, though, is exactly why it is so very difficult for a person who experienced trauma to move on. The trauma has changed everything about them. It has rewired their brain, their nervous system, and even their cells. One of the most interesting studies that Dr. van der Kolk discusses is the fMRI (functional MRI) tests that were performed on a couple, both of whom were suffering from PTSD as a result of being in a horrific car accident. The couple both survived, but couldn't move on. In the MRI, each individual was read a scripted scenario which they each had written as to what it was like to be in that car crash. As a result, each person began to experience flashbacks to the accident. What the doctor's discovered was that in the midst of the flashback, the brain was reliving the experience as if it were happening right then. There were not brain functions visible that would indicate it was a memory, those parts of the brain had essentially shut down. Our children cannot just 'get over it', because their brain is constantly telling them that the trauma is happening RIGHT NOW, whenever any sort of memory associated with it is triggered.

It this one little bit of information alone doesn't convince you to read it, here are some other little excerpts that I marked as I was reading it.

"When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present. But because their left brain is not working very well, they may not be aware that they are experiencing and reenacting the past -- they are just furious, terrified, enraged, ashamed, or frozen. After the emotional storm passes, they may look for something or somebody to blame for it. They behaved that way because you burned the potatoes, or because you 'never listen to me.' Of course, most of us have done this from time to time, but when we cool down, we hopefully can admit our mistake. Trauma interferes with this kind of awareness..." (p. 45)

Connection and felt safety are crucial to moving out of this pattern.

"One thing is certain: Yelling at someone who is already out of control can only lead to further dysregulation. Just as your dog cowers if you shout and wags his tail when you speak in a high singsong, we humans respond to harsh voices with fear, anger, or shutdown and to playful tones by opening up relaxing. We simply cannot help but respond to these indicators of safety and danger.

Sadly, our educational system, as well as many methods that profess to treat trauma, tend to bypass this emotional-engagement system and focus instead on recruiting the cognitive capacities of the mind. Despite the well-documented effects of anger, fear, and anxiety on the ability to reason, many programs continue to ignore the need to engage the safety system of the brain before trying to promote new ways of thinking. The last things that should be cut from school schedules are chorus, physical education, recess, and anything else involving movement, play, and joyful engagement. When children are oppositional, defensive, numbed out, or enraged, it's also important to recognize that such 'bad behavior' may repeat action patterns that were established to survive serious threats, even if they are intensely upsetting or off-putting." (pp. 85-86)


And finally, for those of us who have noticed how terribly out-of-touch some of our children can be with what is happening inside of them.

"However, traumatized people chronically feel unsafe inside their bodies. The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.

The more people try to push away and ignore internal warning signs, the more likely they are to take over and leave them bewildered, confused, and ashamed. People who cannot comfortably notice what is going on inside become vulnerable to respond to any sensory shift either by shutting down or by going into a panic -- they develop fear of fear itself.

We now know that panic symptoms are maintained largely because the individual develops a fear of the bodily sensations associated with panic attacks. The attack may be triggered by something he or she knows is irrational, but fear of the sensations keeps them escalating into a full-body emergency. 'Scared stiff' and 'frozen in fear' (collapsing and going numb) describe precisely what terror and trauma feel like. They are its visceral foundation. The experience of fear derives from primitive responses to threat where escape is thwarted in some way. People's lives will be held hostage to fear until that visceral experience changes." (pp. 96-97)

Obviously, there is a lot to digest in this book. But it is ultimately extremely hopeful in regards to the future of people affected by trauma with new discoveries in regard to how trauma affects the body and what treatment is ultimately helpful. Highly recommended.

3 comments:

LucyL said...

Hmm. So what is the flavor of treatment they come up with?

Donna said...

This would have been very helpful about 10 years ago. :/

thecurryseven said...

Lucy -- The book details several, but at the root of each of them is a sense of felt safety. Without that, the higher order functions of the brain cannot engage and even begin to work on sorting it all out. To that end, the connected parenting model really does seem to be most inline with providing this.

Donna -- I agree. It's what I think a lot about whenever I read about the newest brain research. Instead, ten years ago the 'best' we were offered was Nancy Thomas and holding and a lot of strict and non-deviating consequences. Which we both know didn't help one little bit.

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