Brains of Trauma Survivors

A Chapter by WindSinger

A paper that examines the physiological effects of trauma and possible therapies

Over the years psychologists and therapists have treated people in many different settings to treat a wide range of issues and defects. One of the many things they treat is trauma. The American Heritage Dictionary defines trauma as an emotional, mental, or physical way of harming an individual. Trauma can be caused by a series of events or experiences and has varying symptoms from person to person.

Trauma can be caused by physical, mental, or emotional injury. Events that might cause such injuries include hospitalization, moving to a new location, violence, war, terrorism, or mass disaster. Other experiences include separation from parents, death of a friend, family member or pet, divorce, anxiety, pain, fear, and loss of trust. However, since there is such a variety of experiences that cause trauma this paper will focus on domestic violence.

“Once upon a time there was a girl,

In her early years she had to learn,

How to grow up living in a war she called home,

Hurt me to see the pain across my mother’s face,

Every time my father’s fist put her in her place.

Hearing all the yelling I would cry up in my room,

Hoping it would be over soon.” ~I’m OK song lyrics by Christina Aguilera

Christina Aguilera’s song reflects much of what many children in domestic violence situations go through. However, it is not these children’s experiences that will be the focus of this paper. This paper will examine how domestically violent situations physically impact the brain and the thinking processes of these victims.

Neuroscientist and psychiatrist, Dr. Bruce Perry, has been working for the past twelve years to understand how trauma impacts young children. During this time, he has been working to refute an old theory that children have a natural resiliency and have the natural ability to just “bounce back” after traumatic situations (Perry-Szalavitz, 1). In his research with animals, he tested young animals in stressful experiences in a laboratory.

In these tests he began to observe that during these tests, the subjects had undergone physiological brain changes (Perry-Szalavitz, 1). Numerous animal studies have shown that even minor stress during infancy can have a significant impact on the architecture and chemistry of the brain and therefore on behavior (Perry-Szalavitz, 1). Then a thought arose in Mr. Perry, could this also be true for humans?

This question began to surface even more as he began his clinical work with young children. In his clinical work he found that a good majority of the children’s lives were filled with chaos, neglect, and/or violence. If these children were adults they would have been considered for diagnosis of Post Traumatic Stress Disorder (PTSD). However, these children were being treated as if their attention and behavioral problems pop out of thin air. These children experienced trauma, what would be abnormal is that such experiences did not have a profound effect on children.

Often times when a person is exposed to violent situations, children and adults, can develop an acute or severe form of Post Traumatic Stress disorder. This is a disorder that does not discriminate against age, sex, or race and can be triggered by what would be called major traumatic situations such as natural disasters, war, a prison stay, assault, or rape. Any of these kinds of events is enough to cause stress on anyone. However, how each individual reacts to those situations is unique to the individual. A person can become severely traumatized to the point of not being able to function or other times not show any sign until months after the event or situations has occurred. Also not everyone who has been abused or that has been through a major trauma gets PTSD.

Some symptoms of PTSD include three main categories. The first of which is a ‘re-experiencing’ state, where the patient is reliving the event again and again, which could be in a variety of ways. For instance, the person could be having frightening dreams, memories of the events (some individuals call these flash-backs), or become very upset at the anniversary of the event (Naparstek, 26). The second is avoidance, a person may not remember important aspects of the trauma, have a lack of interest in normal activities, feelings of detachment, sense of having no future, emotional ups and downs, less expression of moods, staying away from people, places, or objects that remind the person of the event (Naparstek, 26). The third is arousal, during arousal the person may have irritability, sleeping problems, difficulty concentrating, and exaggerated response to things that startle that person (Naparstek, 26). Many of these symptoms are also red flags for abuse or depression. However, that does not imply that a person with a few of these symptoms has been abused or is depressed.

When reflecting upon the abusive situations these young children have had or having to undergo, is it surprising then that these young children were in his office for therapy? No, because these children were responding naturally to a highly stressful situation. How then do these environments affect the neurobiology of these children or the general populous? In Dr. Bruce Perry’s online mini-courses he explains that a child’s brain has developmental stages. He states that if the developmental stages are to be nurtured for children then they need to be exposed to consistent, predictable, nurturing, and enriching experiences. However, if children are exposed to neglect, chaotic, and terrorizing environments, they will show significant functioning disabilities.

In the threat of a traumatic situation the body has a reaction called the fight or flight response. This reaction is characterized by a large increase in the activity of the sympathetic nervous system, resulting in increased heart rate, increased blood pressure, respiration, a release of stored sugar, increased muscle tone, a sense of hyper-vigilance, and the tuning out of all non-critical information. All this is a result of the chemical adrenal from the adrenal glands. According to Dr. Perry’s online course, all these actions prepare the body to fight or run away from the potential threat.

After a threat or stressful situation has been removed this triggers the activation of the parasympathetic system. This is characterized by decreased blood pressure, decreased heart rate, the complete mobilization of sugars through out the body slows down, the state of hyper-vigilence also goes down partially, and the person begins to pay more attention to internal events. This is when the person begins to feel fear, anxiety, and begins to make sense out of what just happened. Because the event or situation was not part of a person’s daily life or never been part of their life experience, the brain will attempt several ways to understand and gain “control” over the situation. This is when PTSD begins to set in. According to Dr. Perry, children may go through re-experiencing by talking about the event over and over again. Along with re-experiencing of the event mentally, they also experience the feelings and emotions that go along with the event. In other cases, the children may also use avoidance mechanisms where they will withdraw within themselves to escape from the experience. What happens is the child will focus inward towards ‘inner worlds’ to avoid invading thoughts about the event and therefore avoid the pain. Often when children are overwhelmed with physical reminders about their experiences they will mentally dissociate. This causes them to appear as though they are staring off into space. These reactions occur when the child is not able to physically avoid the reminders.

Such reactions to traumatic events can be understood as natural biological events that are results of unwanted memories. It makes one wonder if there is any possible way

to forget or to remove such memories and still be a functioning member of society. But where is memory formed and how does it affect a persons functioning?

“Memories are groups of neurons that fire together in the same pattern they are activated in,” (Rita, 176). What does this mean? This means that there are literally networks of neurons that are linked to one memory, and are formed through a process called long-term potentiation (LTP). What happens is, when two cells are firing they come together to activate and create a bond. Once this bond is created it goes into a stand by mode until an external stimuli activates these cells (Rita, 176).

Can memory become “lost” or be removed? Most often as adults get older, they loose brain cells, or may end up with degenerative diseases like dementia or Alzheimer’s disease. However, dementia or forgetfulness can also be caused by neurological damage as well. For instance, if a child is beaten or hit in the head on a constant basis this could result in brain damage. Such damage could be enough for brain cell loss. If cells in certain parts of the brain are lost so too are certain abilities to function.

When Dr. Perry spoke at the National Art Therapy Conference, he said that the brain’s functions have a systematic hierarchy of importance. The system of hierarchy is based on what the body needs to survive. The functions start with the most basic needs such as breathing then go up in complexity and ending with abstract thinking. Each of these functions is associated with a particular brain region. The simplest of associated functioning is the brainstem, then the diencephalon, going to the limbic, and lastly the neocortex.

As brain function becomes more complex so do thoughts and actions. Dr. Perry stated that most often when children who are or were being abused become stuck in lower brain functions. How can children who are stuck in lower brain functions worry or even think about higher brain functions (math, reading, etc.) that school forces them to? It is no wonder that these children have behavioral and attention problems. These abused children perhaps have other things that their body or minds deem more important. If they will be beaten, will be able to eat, or even have a home to go to. Any of these things could be a possibility.

In Dr. Perry’s research, he also noticed that the coping strategies mentioned previously coincide with developmental stages. He states that most often it is young children that will develop dissociative disorder because of their size and being forced to be submissive (Perry-Szalavitz, 1). He also states, that he noticed that adults and adolescents use more of the avoidance mechanisms (Perry-Szalavitz, 1).

All these mechanisms are human survival instincts that occur when a person feels as though they are being threatened and, the longer that a person is exposed to such environments the worse the coping mechanism will be. How then can a person who is or was under these circumstances cope in a more healthy way? Discussed previously was the possibility of removing the memory but, without these neuron networks certain functions could be lost and/or damaged. What then could be a healthy resolution for victims?

At the National Art Therapy Conference, Dr. Perry talked about a theory that he called the Theory of Change. Upon which, he stated that in order for change to occur in the brain, we as the human race need to change the nature of our relationships. He stated that this is the root of the problem. Aside from the fact that we live in a society full of attention and touch starved children, we are creating systems that deteriorate human relationships. How do you ask? Think about it, modern humans work and are constantly on go from place to place. Most adult human beings spend most of their time in the work place and more children are being sent to over crowded day cares. We rarely spend time with our families, and more extended families are becoming isolated because our lives are filled with a constant rush of the never ending to do list. Dr. Perry states that human beings thrive in relational situations; however our modern civilization has been growing apart from our families and close relationships to create selfish individuals. In our modern world we crave human interaction but are going down a path of self destruction.

It is with human interaction that neurons in our brains fire and make neural connections however, it is the space between the neurons and humans that healing, learning, and destruction occur. Without human interaction humans fall into unhealthy self-destructive behaviors and completely degenerate. In order to heal those behaviors human beings must become more humane. In order to be humane, one must exemplify the capacities for caring, sharing, listening, value, empathy, and compassion. Being a compassionate person develops when he/she has been cared for, shared with, listened to, valued, and nurtured. There is a saying that just because you are born human, that does not mean that you will be a humane being. Without this humane care giving our capacity to express true humanity is lost, and may even be destroyed.

Where then can we create an environment that is humans can freely express their pains, feel safe, and come together for constructive human interaction? Dr. Perry stated, in many cases art, art therapy, and other performance therapies have shown the ability to create these needed environments. These therapies provide safe and healing environments by utilizing repetition, patterns, and rhythmic movements that are vital components to reaching the lower brain functions where many of these patients may be stuck. Conventional therapy only reaches the higher brain functions. How then can trauma patients be properly treated if the therapy given to them is not working as it was once thought to?

In sum, trauma patients are a special needs group of people who need to be therapeutically treated different than they have been for so many years. The brain, the thinking, and actions of these individuals are different than a healthy functioning person. Their thoughts, actions, and brains are more focused basic survival than other higher brain functions such as abstract thinking. The survival mode they are stuck in is the result of some situation or event that has rattled their day to day experience of life and thus impaired their ability to function. These chemically and behaviorally imbalanced individuals need positive, safe, and humane environments to regain balance from the situation or event. Creating these environments and sustaining them is the key component in their healing process because these patients need to learn or relearn these basic tenets to be healthy functioning humans once again. Perhaps these environments will serve as a model for future generations to come up with healthier, more effective and humane ways for modern living.