Trauma: How it affects the brain, how it can be effectively treated, how it benefits thriving relationships.
by Dr. Richard Jordan
Trauma and Brain Function
The areas of the brain that register trauma are in the limbic system, also referred to as the “old brain.” Some of the specific areas of the brain that are involved include the thalamus, the amygdala, and the hippocampus. These areas of the brain are intimately linked with emotional expression and body responses to thoughts and emotions.
Most sensory input is processed by the thalamus and sent to other parts of the brain. The amygdala records sensory events and experiences that are novel or out of the ordinary, so that traumatic events are especially stored there. And it is the amygdala that sends information to the body to respond when certain traumatic memories are triggered.
So, the challenge for effective therapy is to somehow access the “energy charge” of the trauma memory in the amygdala in a way that dissipates it and allows the person to function without being overwhelmed by traumatic memories. Unfortunately, many proposed treatment modalities are either ineffective, or re-traumatize the patient.
Trauma Treatment Options
A therapy that works strictly through the higher thought areas of the brain, the prefrontal cortex, are unlikely to be effective because this area of the brain does not communicate with the limbic system in a way that yields any benefit in the relief of trauma symptoms. As such, Cognitive Behavioral approaches might not be effective.
I offer a brief note here about what is an effective treatment. At best, effectiveness is determined by scientifically sound controlled studies. There is much new work being started and proposed in the study of effective trauma treatment. In the results available thus far, it seems that some are claiming effectiveness of their methods because their patients achieved significant benefit during the study. However, as goods scientists, it is important to also look long-term, to see if the benefits are lasting. It is also important to look at the effectiveness of placebo treatment, and to tease out the benefit of simply having the patient paid more attention to. Some treatments claiming to be effective are no more effective than placebo treatment, but this fact is sometimes not openly offered. Also, when looking at long-term data for Prozac, often prescribed for PTSD symptoms, the benefits seem to abate after the Prozac is stopped. This suggests that the emotional/body energy of the trauma is only suppressed by the medicine, and re-emerges later off-medicine.
Therapies that are being found more effective include the Eye Movement Desensitization and Reprocessing (EMDR) technique, somatic techniques, opposite-hand writing, and certain play therapy techniques with children.
EMDR is a widely growing technique that is becoming less controversial as its success continues to be demonstrated. It seems to be effective not only for trauma treatment, but for a variety of other challenges that people often bring into therapy. As it has evolved, fewer therapists are actually using eye movement, but instead are using tapping or other devices. It is now widely believed that eye movement is not necessary to yield therapeutic benefit, but that the important thing is to provide “alternating bilateral stimulation” or BLS. For more about EMDR and BLS, see the following sites:
Somatic techniques focus the patient on his or her body sensations, so that access to the stored traumatic energy is through the body experience of it. This can be done in a gentle, gradual way, and in a way that builds a bridge or connection with the thinking areas of the brain. The result is that the patient begins to increase their “psychic carrying capacity” for the traumatic energy, and are ultimately able to discuss the traumatic events in a rather matter-of-fact way, without emotional charge. Often they may something to the effect of, “It’s over, I’m done with it.”
A somatic approach also emphasizes the patient’s, and the patient’s body’s, wisdom and timing, such that he or she develops their own resources to process and move through emotional material. Because the result is a person who is very present with their body experiences, there are many side benefits, including better health, more presence in relationships, and generally a more joyful way of being. Presence and awareness yields a conscious dominion over one’s responses to life experiences.
Two somatic approaches which I have found to be effective are Body Centered Transformation by Gay and Kathlyn Hendricks, and Somatic Experiencing by Dr. Peter Levine. Links to their sites, and other related sites follow.
A skilled therapist will combine trauma healing techniques as appropriate for each patient and situation. For example, I have found myself using EMDR, Somatic Experiencing, and Gestalt approaches all in the same session at times, according to where the patient found himself during the session.
Trauma Healing and Thriving Relationships
When many of us think of trauma, we think of car crashes, abuse, sudden or unexpected death of loved ones, and such. However, consider that we have all experienced traumas in our lives, to some degree. Each of us differ in how resilient we are in managing or coping with traumatic life events. No matter what the nature of our life traumas, each of us learn some version of the following: The people who are supposed to love us all the time, sometimes hurt us. No matter how loving and enlightened our parents might have been, we experience some forms of traumas at their hands. For example, a child who is less than one year old has such little concept of passing time that, when mother leaves the room, the child will fear that she may never return. This has to do with the developmental psychological principle of “object permanency.”
So, we grow to believe, and to fear, that it is not safe to be very close to other people for very long. As we grow into adults, we forget this belief, that is, it becomes unconscious, but it still dictates the ways in which we relate to people, especially our special someone. If we wish to have a thriving, loving, intimate, long-term relationship, one requirement seems to be that we bring this unconscious belief up into the light, so that we increase our ability to be intimate and authentic with our relationship partner.
One of the gifts of relationship is that, given time, it will present us with all the ways in which our beliefs and fears stop us from a deep, thriving, lasting love. As one becomes aware of these beliefs and fears, one has the choice and opportunity to grow and evolve as a human being, and to increase the flow of loving expression in your relationships and in the world.
Get in touch with San Diego couples therapist Dr. Jordan
Contact Dr. Jordan at firstname.lastname@example.org for marriage counseling, relationship advice, psychotherapy, and relationship healing. Offices in San Diego County, California. (619) 303-5062 Speaking engagements and workshops nationwide.