What is Trauma?

Trauma is an event that is life-threatening or psychologically devastating to the point where persons’ capacities to cope are overwhelmed. Any number of events may be traumatizing, including child sexual abuse, other forms of abuse and neglect, witnessing violence, death or other kind of loss of parents or siblings, abductions, car accidents, plane crashes, social dislocation, and war. Repeated exposure to trauma is called complex trauma.

Following trauma, individuals relive the traumatic event, fragmented memories related to the trauma arise unexpectedly, cognitive, emotional, and behavioral dysregulation occurs, and there is avoidance of reminders of the event. In some cases, survivors of trauma become preoccupied with the traumatic event and may play them over and over in their minds or act them out. Trauma may change brain structures and circuits related to memory and emotion.

Persons who have experienced trauma require a place where they can feel safe and where they can work through the effects of being so emotionally hurt.  

Trauma and Neurobiology 

            Traumatic responses are expectable to extraordinary, overwhelming events. A kind of “hot button” or trigger becomes encoded in the emotion centers of the brain. Memories, emotions, and even actions can be reactivated when persons experience reminders of the original trauma.

Reminders can involve any of the five senses. An example is nine-month old child who screams when he sees a woman with blonde hair because a social worker with blonde hair took him from his biological family into foster care. Michelle, now an adult, becomes anxious whenever she smells pancakes cooking. Her uncle, with whom she lived as a child, used to make pancakes on the mornings after he sexually abused her while she slept. When hot buttons are triggered, persons young and old are at risk to dysregulate; that is, to relive the trauma.

The Hippocampus and Amygdala

Trauma effects the brain. The hippocampus, a pair of horseshoe-shaped structures located on each side of the midbrain about where the ears are, is an important storage point for traumatic memories. The hippocampus not only stores the traumatic event itself but also the context of the traumatic event. Sounds, smells, and other contextual details are stored there become associated with the trauma.

Whenever individuals experience reminders of the event, memories of the trauma flood into awareness. Often the memories and reminders are stored as bits and pieces. When the memories are evoked the memories themselves are fragmented. When traumatized combat veterans hear gunshots or a car backfiring, they may relive battlefield trauma.  The sounds trigger memories stored in the brain.

Cortisol, a stress hormone, is released in response to trauma and the retriggering of trauma. Cortisol can damage brain cells in the hippocampus and even kill them. Thus, some children and adults cannot remember major pieces of traumatic events, possibly because of damage to the cells of the hippocampus.

In addition, the hippocampus matures relatively late in life, perhaps into middle childhood or beyond. This accounts for the relatively few memories that individuals have of their early lives. Children who have trauma early in life, therefore, may have not memory of these events.

However, another brain structure, located near the hippocampus, matures quite early and can store the emotional component of trauma, though not the memories themselves. This structure is the almond-shaped amygdala, which also comes in pairs. Very young children who have experienced trauma may have no memory of the trauma, but the trauma is encoded in the amygdala.

High Road and Low Road Responses

When individuals relive trauma and become dysregulated, reminders of the traumatic event trigger brain circuits that by-pass the neocortex, which is the brain’s seat of reasoning. Researchers call this the low-road response because the response goes directly to the emotion centers including the hippocampus and amygdale. Low-road responses do not engage reasoning which is located high in brain in the neocortex, as already discussed.

The high road response involves the triggering of traumas, but individuals are able to manage the trauma and not dysregulate because the brain circuits present in the neocortex are engaged. Without the engagement of reasoning, survivors of trauma are on automatic. Whatever is encoded in the emotion circuits will be activated.

Varieties of Responses to Triggers

Individuals with histories of trauma may respond prosocially, antisocially, self-destructively, inappropriately, and even to leave the scene or enter more deeply into it psychologically through disassociation. Antisocial, self-destructive, and dissociative responses are more likely if the traumatic events include violence, abuse, and neglect.

Some individuals respond prosocially and do so automatically. They seek out people who help them feel safe. Meditation, prayer, and vigorous exercise also are automatic responses to the effects of trauma. The warmth and understanding of friends and families are important to recovery from trauma, but often professional help is required. Trust in other people is associated with these prosocial responses.

The other responses to trauma are signs that individuals have not been able to find anyone who helps them to grapple with the effects of trauma and to soothe and reassure them. They have not, therefore, experienced the soothing and reassurance that they require in order for the emotion centers to return to peaceful states. Their anti-social responses are attempts at re-regulation.

Children and adults who have experienced child sexual abuse or other abuse-related  and violence-related traumas may respond anti-socially through hurting others or destroying the property of others. Physical and verbal aggression, teasing and harassing others, harming animals, and sexual acting out against other children may be signs of trauma.

Self-destructive responses include using drugs and alcohol, cutting, gambling, compulsive shopping, and recklessness including driving at high speeds and risky sexual behaviors.

Inappropriate responses are humming, tapping, and agitation. Often persons who behave this way do not realize it. Using sexual stimulation, such as sexually explicit media and masturbation, to re-regulate is another form of inappropriate responses to triggering of trauma. Some people, including children, use sexual stimulation to lift their mood and therefore to re-regulate themselves.

Sometimes persons disassociate, which means, psychologically they leave the situation or enter more deeply into it. When individuals leave the scene through disassociation, they may feel as if they are looking down at themselves and at whatever is going on. They may feel numb and remote from themselves, a condition called depersonalization.

Some people literally leave the scene and travel a great distance. They may have no memory of what triggered their travel and may have amnesia. Others may feel as if they become another person at least for a while and have no memory of being anyone else.  This is called dissociative identity disorder or DID.

People who have been traumatized may enter more deeply into the trauma and believe the events are happening in real time. In these states, they re-enact traumatic events. Combat veterans may fire a gun at someone whom they think is an enemy combatant. Children and adult survivors of child sexual abuse may re-enact aspects of their abusive experiences.

Learning to Manage

Individuals can work through the effects of trauma if they connect to persons who understand trauma, who provide a sense of safety, and who can carefully and sensitively guide traumatized persons to deal directly with the trauma. Persons who can provide this help typically are well-trained professionals.

Read more about trauma, attachment and feeling safe, and neurobiology by going to http://www.lulu.com/content/3987178. This link will take you to The NEATS: A Child and Family Assessment that is available as a FREE DOWNLOAD.