Trauma awareness is having a moment right now. Perhaps the collective experience of the pandemic has created a lot of level ground when we talk about how terrifying, out-of-control-moments tax our health and even our future capacity for handling stress.
When we talk about trauma, we can talk about single, impactful life-events that caused threat of harm and potential death. Surviving a tornado or a war are a few examples. For some, surviving a car accident can also be a major life trauma. Not everyone has a traumatic response or develops Post-Traumatic Stress Disorder after terrifying experiences. That is significant about trauma: some individuals are more vulnerable and others appear to weather the same events due to possible protective factors. Both our genetic inheritance and our lived experience contribute to the delicate balance of risk and protection.
Complex Trauma Disorder describes the condition of how chronic and accumulated traumas impact our mental health. For example, threats to physical and emotional safety within the first years are known to create critical psychological wounds. Additionally, the residue of these experiences become a liability for future health, manifesting powerful changes in brain and neurological health. Children who experience abuse, neglect, witness domestic violence, are separated from family, or survive other traumatic events show changes in their physiology (National Child Traumatic Stress Network, 2021). This essentially means that a brain impacted by traumatic stress will operate differently, some parts working overtime and others under-performing. Let’s take a look at some specific differences and how that shows up in more complex situations, like relationships.
One area of the brain that begins to work overtime after intense or prolonged fears for safety is the “fear center” or the amygdala. If you haven’t heard of this little nut-sized cluster deep inside our brain, you should get familiar. Imaging of healthy vs. PTSD or CPTSD survivors shows enlargement of the amygdala, in a sense it appears inflamed. There is greater effort, resources and priority of energy in the brain to be constantly “on alert”. This effort to identify danger might show up in relational patterns. Complex trauma can impact the functions of trust, seeing threat in even benign situations, or trigger-fast responses to protect and defend. To the onlooker an individual might show intense and sudden emotion in the context of triggering situations. Or there might be inhibition to get close to others, intimacy being a threatening and vulnerable state for them.
When the amygdala is calling the shots, it can become nearly impossible for a person to truly relax and feel at ease. Not surprising, higher levels of addiction follow as trauma-survivors look for any way they can to relax and feel less threatened or overwhelmed. Unfortunately, the side-effects of alcohol and drugs create even less ability to regulate emotion, interrupt precious sleep and put the person at risk for future victimization.
Also impacted by chronic traumatic stress, the “emotion center” of the brain, or the part that works to manage the intensity of our emotions fails to do its job completely. The anterior cingulate cortex coordinates several functions in the brain, it specifically our ability to recognize what we are feeling, manage the intensity of our feelings and integrate emotionally charged situations into a meaningful experience (Stevens, et al, 2011, accessed Psychiatry Online, 9.16.24). While we might assume that trauma creates the experience of constant emotional pain, the reality is that PTSD and CPTSD survivors note that they often feel numb, have little to no emotion or even strange lack of fear in certain situations. Neuroimages comparing healthy brains to those struggling with PTSD show lower activations in the emotion center (ACC). This adjustment to encountering extreme fear results in a “shut-down” of sorts. The part of the brain recognizing emotion compensates by turning down the volume on both good and bad emotion. Literally the activity of managing emotion goes down, also resulting in inability to connect raw emotional data and input from the event into the “thinking center” where we process and make sense of things.
Another aspect of the ACC, or “emotion center”, is coordinating motivation and managing the traffic of input. Individuals with lower ACC activation struggle with concentration and motivation. These symptoms are often seen in cases of depression as well as trauma. Ironically, the lack of coordination from ACC also results in higher perception of pain. It’s easy to see how depression and chronic pain become familiar partners in the world of trauma-responses. The memory of a world-out- of-control has now become a realty within the body and mind of the survivor; pain, emotion and hope are all elusive and chaotic.
Last, the “thinking center” or the prefrontal cortex is also under-active in trauma survivors. This is the ultimate manager of the brain, “logical” or rational thought comes from successful operations within this part of the brain. This helps us organize information, focus our attention where we want, delay gratification and make decisions based on a variety of input. Most of us are familiar with concentration and impulsivity connected with Attention-Deficit and Hyperactivity Disorder. The very same “thinking center” is shown to have insufficient energy and oxygen for ADHD individuals. Trauma is often a foundational cause of difficulty concentrating and handling impulses and should always be ruled out prior to medicating or diagnosing ADHD.
While each person will have different responses to trauma and varying intensity in their response and adaptation to living in fear, there is clear evidence that chronic stress from poverty, toxic and abusive relationships or systemic discrimination can be more than enough to alter the structures in our brains. Our amazing brains adapt and change their functions to find “safe” ways to survive in an unsafe world. These changes often drive us to unconscious responses and attitudes that take time to uncover.
The great news is as we learn and begin to evaluate our responses to the world, our brain begins to reactivate the parts that are “underperforming”. By exaggerated use and repetition our “thinking center” begins to flex its muscles. Through mindful work to calm our bodies and connect to our emotions, the “emotion center” gains vocabulary and efficiency, finally helping gate-keep the input of emotions into a less overwhelming experience. What seem small as words and fluffy as thoughts represent energy, coordination and returning power to experience life as manageable again.
