What is trauma? According to the American Psychological Association: :
Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.
That’s certainly the prevailing definition of trauma. But is there more to it? Assuredly. Trauma can result in myriad symptoms that go far beyond “even headaches and “nausea.”
The more I research the brain, the more I’ve come to realize that much of what we call “depression, anxiety, fear,” and a wide range of other “disorders,” are due, in varying degrees, to trauma. What we know is that trauma tends to be induced by an incident or series of incidents. It can happen when you’re young (when you have a tendency to suppress the memory) or when you’re older (when you’re more likely to maintain the memory). Trauma is, essentially, the brain’s retention of a stressful event or experience–and after it’s done, it becomes the memory of that event or experience that provides the trauma trigger. Trauma–the experience. And contrary to the simplistic definition of trauma listed above, it experienced in a wide variety of ways.
Trauma–it’s complicated. According to Dr. Christine Courtois’s article, “Understanding Complex Trauma, Complex Reactions, and Treatment Approaches” complex traumatic events and experiences are:
(1) repetitive, prolonged, or cumulative (2 ) most often interpersonal, involving direct harm, exploitation, and maltreatment including neglect/abandonment/antipathy by primary caregivers or other ostensibly responsible adults, and (3) often occur at developmentally vulnerable times in the victim’s life, especially in early childhood or adolescence, but can also occur later in life and in conditions of vulnerability associated with disability/ disempowerment/dependency/age /infirmity, and so on.
In other words, it’s complicated, and “one size does not fit all” when it comes to trauma. Memories involve a variety of components in the brain. The brain’s memory is so powerful, that most of the time, you’re completely unaware that this most incredible 3 lb. gelatinous computer is recording things (even while you sleep)–but it’s always recording.
What about PTSD? Post Traumatic Stress Disorder, or PTSD, is a syndrome that occurs when one cannot “reset” and go back to a normal life after a traumatic event (or once an event becomes dominant in one’s life). Dr. Lynn Margolies, a psychologist and former Harvard Medical School faculty and fellow, breaks down PTSD into the following categories:
Hyper-arousal is when the traumatized person’s physiology is in high gear, having been assaulted by the psychological impact of what happened and not able to reset. The symptoms of hyperarousal include: difficulty sleeping and concentrating, being easily startled, irritability, anger, agitation, panic, and hypervigilance (being hyper-alert to danger).
Re-Experiencing includes intrusive memories, nightmares, flashbacks, exaggerated reactions to reminders of the event, and re-experiencing (including re-experiencing physical symptoms when the body ‘remembers’).
Numbing includes feeling robotic or on “automatic pilot” – disconnected from feelings and from vitality, which is replaced by a sense of deadness. Symptoms of numbing/avoidance include: loss of interest in life and other people, hopelessness, isolation, avoidance of thoughts and feelings associated with the traumatic event, feeling detached and estranged from others, withdrawal, depression, and emotional anesthesia. Preoccupation with avoiding trauma or feelings and thoughts related to trauma can become a central focus of the survivor’s life. [source]
Although it’s not mentioned above, these symptoms are very closely aligned with fight/flight/freezing associated with the ancient brain “survival response,” and the negative feedback loop (which I’ve discussed quite a few times before). It’s my view that these symptoms are far more common than people realize, and often go undiagnosed because there’s no real “test” for them other than some very broad-based “if this, then that” criteria (such as listed here in the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5). But if you are having some symptoms, but not others, or are not diagnosed by someone with expertise in this area, you can be put on a “diagnostic” treadmill with no clear final conclusion about what’s happening to you (as I was), which can lead to increasing symptoms, because of a lack of knowledge about what’s happening. You can easily think that you’re losing your mind, as medical specialists wind up “guessing” about your condition. It is my contention that everyone suffers from trauma of some sort, in some way or another–it’s almost inevitable if you’re lived at all. Life is a dangerous, often frightening experience, and the wonderful, agnostic brain records it all in ways we’re only just beginning to discover. This is good news–and bad–because the brain honestly doesn’t “care” what it records; it’s just going to record what you experience, and how that eventually comes to light, consciously or sub-consciously, one can only guess. Eventually, trauma, anxiety, stress, freezing responses–these may well all be considered components along the same spectrum.
Take the veteran who returns from war. Let’s say he or she has been in firefights and has witnessed their friend being brutally killed–or say, he or she has brutally killed someone. The memory of this experience was recorded and stored in vivid detail–the brain retains extreme circumstances in high def. But the memory itself may be “repressed,” in effect, shoved down deeply in the brain so that the conscious mind is largely unaware of it (the brain is good at defense mechanisms like this, too). But then one day, walking down the street, the vet, who has had trouble sleeping, feels depressed or anxious, and doesn’t know why, suddenly smells or hears something that “triggers” or “stimulates” the traumatizing memory. Suddenly, it’s all read–as if it were happening for the first time. The brain triggers all the associated body / brain systems it “thinks” are needed to function to deal with it–whether the threat is real or not.
One of the saddest letters ever written. The description below is a heart-rending explanation of how one individual–a soldier who fought in Iraq–experienced trauma. It offers, in painful detail, the experience that can happen to someone who has been severely traumatized, and what the brain can do to such an individual–all in “service” of survival. Passages from the letter are as follows:
Daniel Somers was a veteran of Operation Iraqi Freedom. He was part of Task Force Lightning, an intelligence unit. In 2004-2005, he was mainly assigned to a Tactical Human-Intelligence Team (THT) in Baghdad, Iraq, where he ran more than 400 combat missions as a machine gunner in the turret of a Humvee, interviewed countless Iraqis ranging from concerned citizens to community leaders and and government officials, and interrogated dozens of insurgents and terrorist suspects. In 2006-2007, Daniel worked with Joint Special Operations Command (JSOC) through his former unit in Mosul where he ran the Northern Iraq Intelligence Center. His official role was as a senior analyst for the Levant (Lebanon, Syria, Jordan, Israel, and part of Turkey). Daniel suffered greatly from PTSD and had been diagnosed with traumatic brain injury and several other war-related conditions. On June 10, 2013, Daniel wrote the following letter to his family before taking his life. Daniel was 30 years old. His wife and family have given permission to publish it.
My body has become nothing but a cage, a source of pain and constant problems. The illness I have has caused me pain that not even the strongest medicines could dull, and there is no cure. All day, every day a screaming agony in every nerve ending in my body. It is nothing short of torture. My mind is a wasteland, filled with visions of incredible horror, unceasing depression, and crippling anxiety, even with all of the medications the doctors dare give. Simple things that everyone else takes for granted are nearly impossible for me. I can not laugh or cry. I can barely leave the house. I derive no pleasure from any activity. Everything simply comes down to passing time until I can sleep again. Now, to sleep forever seems to be the most merciful thing.
This is what brought me to my actual final mission. Not suicide, but a mercy killing. I know how to kill, and I know how to do it so that there is no pain whatsoever. It was quick, and I did not suffer. And above all, now I am free. I feel no more pain. I have no more nightmares or flashbacks or hallucinations. I am no longer constantly depressed or afraid or worried. ~ Daniel Somers, RIP
I’ve read this letter a couple of times now, and every time, it hits me: we actually know how to control many of these symptoms. We actually know that people who are traumatized and are experiencing extreme physical symptoms aren’t “making it up.” It’s clear that this is not the case. In the case of traumatized veterans, the symptoms can be–and clearly are–impossible to live with in a consistent, chronic way. Everything this poor, highly intelligent vet describes is a textbook explanation of a traumatized individual. Incredibly sad story, but elements of this are something that I–someone without a military past–have experienced.
Unfortunately, I don’t believe that his case is not unique; a recent study seeks to determined why the suicide rate is so incredibly high among vets returning from war
Trauma and Meditation: Reason for hope. According to a 2013 a study, there is reason to hope for traumatized individuals and those with PTSD.
A new collaborative study from the University of Michigan Health System and the VA Ann Arbor Healthcare System shows that veterans with PTSD who completed an 8-week mindfulness-based group treatment plan showed a significant reduction in symptoms as compared to patients who underwent treatment as normal.
The results of our trial are encouraging for veterans trying to find help for PTSD,” says Anthony P. King, Ph.D., the study’s lead author and research assistant professor in the U-M Department of Psychiatry, who performed the study in collaboration with psychologists at the VA Ann Arbor Healthcare System. “Mindfulness techniques seemed to lead to a reduction in symptoms and might be a potentially effective novel therapeutic approach to PTSD and trauma-related conditions.”
For those who have been following the trajectory of mindfulness meditation (and it’s increasing acceptance in the West), this comes as no surprise. Addressing feelings, runaway thoughts, and understanding how to deal with them through insightful meditation builds up resilience in the brain to stress, anxiety, depression, and fear. The data are increasingly incontrovertible, and that’s good news for a culture that has become used to taking pills to deal with their internal mental strife, rather than use the brain’s own incredibly powerful tools to do so.
There is also this: The Neuroscuplting Institute in Denver. Last year guest writer Lisa Wimberger explained the hope that neuroplasticity offers–a way to re-generate and recreate our neural networks. Lisa is an expert in trauma and has helped hundreds of police officers deal with stress through neurosculpting. Find out more at her web site, http://neurosculptinginstitute.com to find out more.)
Lisa Wimberger, the founder of the Neurosculpting Institute is presenting a workshop at the world-famous Kripalu Center in Massachusetts this June. To find out more about how she developed the program of neuroplasticity, check out this fascinating interview with Lisa, conducted by Tami Simon, the founder of Sounds True (the best known and highly respected organization that sells leading self-help and insight programs, ranging from MBSR training online to CDs by the NeuroSculpting Institute, and everything in between; well worth checking out). The “Weekly Wisdom” interview with Lisa can be found here).
Trauma as a Memory–Someone Else’s
Trauma is a well-known phenomenon, but the brain, as incredibly accurate and high def as it is, sends its owner into a state of panic and excitation, because the brain and the body really don’t recognize that this is not the actual experience, but only a memory, and it triggers the same fight/flight/freeze response that was triggered when the original experience occurred. The thing of it is, some people have more of a predisposition to trauma than others; it’s complex. Levels of resilience to trauma–whether experienced in battle or in a sexual attack, or due to some sort of innate, developed anxiety–seem to vary widely. When it comes to trauma one size most definitely does NOT fit all. In fact, the latest research indicates that memories can be passed down from one generation to another. Um, that’s kind of a huge development. Because if memories can be passed down genetically, theoretically, so can trauma, which is comprised of memories.
New research has discovered that genetic changes are sparked by actions, activities, and external influences–this is a field of inquiry known as epigenetics. We’ve known for a long time that certain influences or triggers can trigger cellular activity at the DNA level (suddenly getting a second chin, just like Dad, in your 50s? That’s a triggered trait! (or too much wine, it’s a toss up!) ;). So, if epigenetics works in our bodies, why not our brains? To follow this logic, it’s now been determined that memories may well be passed from generation to generation. This is big news, indeed. Because if memories can be handed down to the next generation, then it follows that trauma (which is comprised, ultimately of memories of traumatic experience) may have actually be passed down, genetically from generation to generation:
According to the new insights of behavioral epigenetics, traumatic experiences in our past, or in our recent ancestors’ past, leave molecular scars adhering to our DNA. Jews whose great-grandparents were chased from their Russian shtetls; Chinese whose grandparents lived through the ravages of the Cultural Revolution; young immigrants from Africa whose parents survived massacres; adults of every ethnicity who grew up with alcoholic or abusive parents — all carry with them more than just memories.
Like silt deposited on the cogs of a finely tuned machine after the seawater of a tsunami recedes, our experiences, and those of our forebears, are never gone, even if they have been forgotten. They become a part of us, a molecular residue holding fast to our genetic scaffolding. The DNA remains the same, but psychological and behavioral tendencies are inherited. You might have inherited not just your grandmother’s knobby knees, but also her predisposition toward depression caused by the neglect she suffered as a newborn.
Or not. If your grandmother was adopted by nurturing parents, you might be enjoying the boost she received thanks to their love and support. The mechanisms of behavioral epigenetics underlie not only deficits and weaknesses but strengths and resiliencies, too. [source]
This makes intuitive sense, and now the data are getting closer to proving that it makes valid scientific sense, as well. One of the biggest challenges in dealing with traumatized people is determining how much of it is due to a “predisposition” to trauma and how much of it is due to actually stimuli. Now, in light of the latest epigenetics research, predisposition in this case is really a euphemism for “inherent/inherited tendency.” It’s hard to put a value on what this might mean for medicine, the treatment of depression, anxiety, trauma, and a range of other “inherited” maladies:
According to the new insights of behavioral epigenetics, traumatic experiences in our past, or in our recent ancestors’ past, leave molecular scars adhering to our DNA. Jews whose great-grandparents were chased from their Russian shtetls; Chinese whose grandparents lived through the ravages of the Cultural Revolution; young immigrants from Africa whose parents survived massacres; adults of every ethnicity who grew up with alcoholic or abusive parents — all carry with them more than just memories. [source]
Imagine that an “inherited mental hygiene” profile could be developed that indicated the likelihood that someone would develop various anxieties, depression, or trauma-related illness. We know that trauma, anxiety, and stress (all part of the same spectrum of reliving or living in real time, fears and pain through uncontrolled thoughts or somatization stressors) can be treated by complementary techniques such as mindfulness meditation.
Our ancestors are there in every cell of our bodies. There are seeds that are planted during your lifetime, but there are also seeds that were planted before you manifested in this body. ~ Thich Nhat Hanh
The Brain doesn’t know the Difference Between Reality and Memory. According to Dr. Dispenza, you can turn on the stress response just to a thought alone. The Limbic, or ancient brain, is triggered by an threat event–real or imagined–which then leads to the he fight/flight/freeze response. So a memory, to your brain, can be just as real to the original stimulus, leading to increased heart rate, blood pressure, dilated pupils, blood flow to your extremities, all in preparation to do battled or flee. As Dr. Dispenza puts it, however, what was once an adaptive response to actual threat, has become a maladaptive reality, “because when we turn on the stress response, and we can’t turn it off, now we’re headed for disease.” For more on this, please see this post.
Some final thoughts. It would make intuitive sense that the brain is capable of passing down memories from generation to generation–after all, just chemicals and DNA triggers, whether working around your mid-section, your eyesight, or your brain. I could also see how, to ensure survival, a collective memory capability would exist, to ensure that whatever was occurring in a family line remained in that family line, warts (physical and mental) and all. As per always, more research is warranted, but this fascinating area of inquiry could prove to be one way we identify who is more prone to trauma and who is more resilient to it–something today’s researchers have no remote idea about at this point, as far as I’m aware.
Yours in Mental Hygiene,
The Ancient Brain and Modern Mindfulness