The Neuroscience Behind Trauma

Written by Patricia Nicole Tan, Edited by Harshita Kanwar

        Coping with situations beyond your control feels overwhelming. That helplessness, that weight on your shoulders, it’s exactly what psychological trauma does.

        Psychological trauma refers to the psychological and emotional damage caused by exposure to traumatic events. It creates significant negative effects on an individual’s mental health and overall well-being.

        This trauma leads to various effects, including post-traumatic stress disorder and other psychiatric conditions that may develop after experiencing distressing events.

        One major effect is trauma-related memory. According to Ford et al. (2015), these are memories of traumatic events that individuals may recall after a period of forgetting. Different factors influence this recall, and the memories may not always be accurate.

        Van Der Kolk (2007) also explains that traumatic memories can become disconnected from conscious awareness, resurfacing as sensory perceptions, obsessional thoughts or behavioral reenactments.

        No one, not even a doctor, can judge how a person copes, as every individual handles trauma in their own way. But why do people develop different coping mechanisms when dealing with psychological trauma?

        To answer that question, a reader like you should understand how the brain processes trauma, starting with the amygdala. According to Johns (2014), the amygdala controls emotional responses, especially those involving anxiety, fear, and rage.

        This includes trauma, and several studies have explored its role. Nooner et al. (2013) found that the amygdala, particularly the right amygdala, plays a significant role in trauma symptoms. Tracking its brain connectivity can help determine the effectiveness of therapy.

        For stress disorders, Zhang et al. (2021) linked the amygdala to stress-related psychiatric conditions, including anxiety disorder, depression, post-traumatic stress disorder, and addiction. This highlights how it regulates activity in response to stress.

        Now, let’s focus on memories. The hippocampus, a brain structure, consolidates short-term memories into long-term ones, processes emotions, and supports learning, according to Zhu et al. (2021).

        Research also shows that a smaller hippocampus reduces activation after trauma, making individuals more vulnerable to PTSD symptoms, as stated by Van Rooij et al. (2015).

        This occurs because the hippocampus differentiates between past and present experiences. When it does not function properly, traumatic memories feel as if they are happening in the present, leading to flashbacks and heightened fear responses.

        When trauma also weakens hippocampal activation, regulating fear responses or impulses becomes more difficult. This increases the likelihood of impulsive behavior or emotional outbursts, which often appear in PTSD, according to James et al. (2014) and Netto et al. (2016).

        How about when the brain responds to fear? This is where the prefrontal cortex (PFC) plays a role, as it controls attention, emotion regulation, and complex learning, according to Hilt et al. (2011).

        Similar to the hippocampus, a smaller PFC increases the likelihood of developing PTSD. With less gray matter, extinguishing fear and regulating emotions becomes more difficult, as stated by Stein et al. (2020).

        The prefrontal cortex, specifically the ventromedial PFC, normally regulates fear extinction. However, in individuals with PTSD, this regulation weakens. Jovanovic et al. (2012) observed lower activity in this area, leading to poor fear response.

        But can memories be repressed? Let’s focus on that first. According to Sigmund Freud and Jean-Martin Charcot, when trauma overwhelms a person, the mind automatically suppresses it from conscious awareness.

        However, some researchers challenge this idea. McNally and Geraerts (2009) argue that people may forget or avoid discussing trauma without repressing it in an unconscious way.

        Other studies suggest that traumatic events remain well-remembered rather than forgotten. McKinnon et al. (2014) found evidence contradicting the idea of unconscious repression, aligning more with modern research on how trauma is stored.

        According to Korczyn et al. (2015), another type of memory, “flashbulb memories,” involves highly vivid recollections linked to unexpected, emotionally impactful events.

        The emotional intensity of these memories fades over time, but only for individuals who receive positive support from medical professionals. May et al. (2020) found that those without supportive medical communication retain these memories more vividly.

        False memories also exist, where individuals mistakenly perceive mental experiences as accurate representations of past events. Johnson (2001) studied how these inaccuracies develop.

        The brain fills in gaps by imagining non-experienced events, adding memory-like characteristics such as sensory details. Thomas et al. (2003) called this phenomenon “imagination inflation.”

        The false memory perspective also argues that many recovered memories of trauma may be mistaken. However, not all recovered memories are false. Some remain authentic but were previously unconsidered, as noted by Thomas et al. (2003).

        Hypervigilance also remains a significant mental concern among combat veterans dealing with post-traumatic stress disorder (PTSD), according to Cameron and Mamon (2019).

        Hypervigilance, one of the symptoms of PTSD, involves excessive attentiveness to potential threats. This includes constant visual scanning of the environment, checking for entrances and exits in crowded areas, and staying hyper-alert, as noted by Kimble et al. (2010).

        A case study by Tuerk et al. (2009) described how veterans exhibited compulsive checking behavior linked to their military experiences. This behavior reduces anxiety and often persists even when PTSD remains undiagnosed.

        Now, let’s focus on cortisol. Cortisol plays a key role in regulating blood pressure, immune responses, and helping the body and brain adjust to environmental challenges, according to Staufenbiel et al. (2012).

        O’Connor et al. (2017) reported that higher levels of childhood trauma correlate with lower resting cortisol levels. This suggests that individuals with moderate or severe childhood trauma tend to show weaker physiological responses to stress.

        However, other studies, including Heim et al. (2008), observed increased cortisol levels in individuals with childhood trauma, especially those with PTSD. This indicates that they release too much cortisol in response to stress rather than too little.

        Now, let’s step away from the negative side of brain trauma and focus on the positive: rewiring trauma. But is that even possible?

        Yes! First, Eye Movement Desensitization and Reprocessing (EMDR) offers a non-verbal approach that resolves symptoms from unresolved life experiences by modifying maladaptive information, according to Mevissen and De Jongh (2009).

        EMDR helped reduce PTSD symptoms in two bipolar disorder (BD) patients who experienced trauma, based on findings by Oh and Kim (2014). Hase et al. (2015) also reported that EMDR improved and reduced symptoms of depressive disorder in a case study.

        Perlini et al. (2020) concluded that more studies are needed before recommending EMDR widely for bipolar disorder. However, multiple studies support its effectiveness in reducing depressive disorder symptoms.

        Next, cognitive behavioral (CBT) emphasizes awareness of positive and negative self-talk patterns and behavioral habits, as explained by Gertz and Culbert (2009).

        Sachser et al. (2016) found that trauma-focused CBT (TF-CBT) effectively treated both PTSD and Complex PTSD. Goldbeck et al. (2016) supported TF-CBT as the first-line therapy for post-traumatic stress symptoms.

        Diehl et al. (2014) noted that TF-CBT effectively addresses core PTSD symptoms, especially those related to self-perception and relationships. It also proved safe for high-risk youth with CPTSD without worsening symptoms.

        Lastly, neuroplasticity allows neurons, neural circuits, and the brain itself to modify and reorganize physically and functionally in response to experiences and stimuli, as described by Quartarone and Ghilardi (2022).

        Creative therapies, which engage the right brain through movement, music, art, and drama, help process trauma even when verbal communication becomes difficult, according to Klorer (2005).

        By forming new neural connections, neuroplasticity restructures trauma-affected brain pathways. When words fail, sensory-based therapies enable trauma processing, as explained by Garrett (2020).

        See how fascinating the brain is when it processes trauma and rewires itself? This proves that understanding trauma and its effect on the brain strengthens therapy and mental health support.

        Trauma impacts memory, emotional regulation, and the function of amygdala, hippocampus, and prefrontal cortex. But the brain’s resilience and ability to rewire itself create hope for recovery.

        Therapies like EMDR, CBT, and creative approaches rooted in neuroplasticity show how the brain can heal and adapt. Future research on trauma and memory will deepen the understanding of these processes and improve treatment.

        Recognizing and addressing trauma should involve everyone, whether or not they have experienced it.

        Let us pave the way for more compassionate and effective therapy worldwide.

        And let us empower trauma survivors to regain control of their lives.

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