Video Transcript:

While most of us do not choose it, suffering is an unavoidable part of life.  Much of it is through the traumatic events we experienced, from birth till death, and anything in between.  Every moment and every person we meet can be a potential source of suffering or healing, depending on our perspective.  A trauma story, I believe, is a testament to the strength, courage, and resiliency of the human spirit, both personally and collectively. To understand its story, we have to start from the beginning…

The Beginning - When the Body and Brain are Friends

Thanks to our ancestors and 6 million years of evolution, every infant is born with a set of sophisticated and complex systems to help it survive and adapt to the environment.  Mother Nature provides the hardware while our caregivers provide the software.  This survival system consists of the limbic and sensory systems.  

To keep us safe, our brain is constantly gathering data from our environment for signs of safety or threat using our 5 basic senses.  What we see, hear, smell, taste, and touch all get sent to the thalamus for processing, letting the brain know what’s happening to us.  If a potentially fearful or dangerous situation is detected, this message is relay to both the amygdala in the right brain for quick action and the frontal cortex for slower refined processing.  This is why we can sense danger and act before we even know what it is.  Once the amygdala is notified, it triggers the hypothalamus to release the stress hormones cortisol and adrenaline, ready for a fight/flight or freeze response.  The amygdala also encodes fear emotion to those sensory information and passes them to the hippocampus for memory formation and storage for later access.  This way we can learn from our past experiences and give them proper context should we encounter the same or similar situation again, separating past memories from present reality.  As long as the fear stimulus doesn’t overwhelm the system or we were able to fight or flee the situation, the frontal cortex can inhibit the amygdala's emotional response and the parasympathetic system can stop the stress hormones released, signaling that the danger is over and we can now rest and relax.  “It’s handled.”

This entire process demonstrates a healthy and robust distress response system between the body and the brain.  First, it accurately detects and interprets the sensory inputs, then responds appropriately to the threat, and lastly regulates itself back to a calm and restful state once the threat is over.  As I said earlier, Mother Nature provides the hardware while our caregivers provide the software.  They do that by being attuned to our needs, responding appropriately to meet those needs, helping us put words to what we’re experiencing and feeling, and is available to soothe us when we’re in distress.  If our caretakers do a good enough job,  then we can internalize that sense of safety and care within ourselves and with our environment.  From there we learn to take care of our own needs, protect ourselves, and self-regulate as needed, forming a safe and secure base from which to explore, learn, and grow.   

Now let’s see what happens in the case of trauma when the body and brain are overwhelmed.

During Trauma - When the Body and Brain are Overwhelmed

Trauma is an event or experience of actual or extreme threat of physical or psychological harm that overwhelmed the brain’s and body’s capacity to cope and may have lasting adverse effects if left unprocessed.  

In a traumatic event, 4 things happen to the body-brain connection:

1. The amygdala floods the body with stress hormones and put it in a state of flight/fight or freeze.  
2. This flood of stress hormones shut down the emotional and sensory information flow from the right brain to the left brain cognitive function and blocks the amygdala access to the hippocampus for memory formation, retrieval, and spatial navigation.  This is commonly known as an amygdala hijack when fear takes over.  
3. Due to these communication blockages, the amygdala is unable to receive accurate information about the situation from the left brain or hippocampus to respond appropriately, unable to shut itself down or self-soothe after the danger is over.  
4. This put the body in a constant state of hyper-vigilant and anxiety, with fragmented images and sensations stored in the right brain while traumatic emotions are held in different parts of the body, primarily in the gut, muscle, and skin.  The person is then left with sensory and emotional overload without a coherent narrative and may experience psychosomatic symptoms without any biological cause.  

If these traumatic sensory and emotional fragments are left unprocessed, they can become triggers to re-traumatize the person at any time, causing the person to re-experience the original trauma with all its terror as if it’s happening in the present.  This can lead trauma survivors to overreact and adopt extreme behaviors such as self-harm, addictions, or eating disorders to manage and control these body memories, intrusive images, flashbacks, and painful frightening dissociated affects.  

Post Trauma - When the Body and Brain are Disconnected

Trauma always leaves an imprint on the body, mind, and soul.  It can fundamentally change the way we think, feel, and behave.  I call this the 4 D’s of post-traumatic change.

The first one is dissociation.  This is a biological survival mechanism that separates our conscious awareness in the left brain from the frightening feelings, sensations or memories held in the right brain and body.  Some have described it as an out-of-body experience.  It is a common response to early and/or cumulative trauma, such as in cases of childhood sexual or physical abuse when it’s not safe to be in the body.  This way we can still function by not having to feel or remember the overwhelming distress of the trauma, pretending like it had never happened.  Or we can remember what happened but retell the story in a stoic way, without any feelings attached.  However, being out of touch with one’s feelings and body comes at a great cost.  It resigns the person to live a numb, spaced-out zombie-like existence of just going through the motion but is unable to feel fully alive or be present to enjoy life.  

The second change is dysregulation, both emotionally and physiologically.  As you remember from the beginning, the stress response system can only regulate and soothe itself by having proper communication between the right and left brain, connecting the mind to the body.  However, when the amygdala hijacked the system during trauma, it is now thrown out of balance, leaving the mind and body in a highly anxious and aroused state.  The result is someone who perceived themselves to be in constant danger, gets triggered easily and will react in extreme ways to protect themselves.  They can be paralyzed with fear in one moment and suddenly lash out in a blind rage the next, unable to control their behavior or emotions. 

The 3rd change is defensive behaviors.  Perhaps the most upsetting thing about trauma isn’t the event itself, but what it took away from us: our basic sense of trust and safety in the world.  Without that, the only thing we can do is to protect ourselves from getting hurt again, by any means necessary.  Many of these defensive behaviors are done unconsciously and compulsively, without our conscious awareness of them.  They are grouped into 3 main categories.  The first one is to help us survive the unbearable pain and knowledge of what had happened, by blocking us from the pain and knowledge of the trauma itself.  These consist of primitive defenses such as dissociation, denial, splitting, projective identification, and idealization.  The second category is pain management.  This is to help us control, distract and soothe ourselves when emotional pain, terrifying memories, or negative thoughts intrude into our awareness.  Addictions, obsessions, and compulsions would fall under this category.  The last category is adaptive roles, which help us function with the outside world through compensation and coping strategies.  Over time these roles can become maladaptive, pushing us into extreme tendencies and rigid personality structures.  Eventually, we start believing that these defenses are who we are vs remembering that these are defensive masks that we can take off or use more consciously as needed.

The 4th change is a disorganized inner world.  Trauma doesn’t just cause a rupture of our external life, but it also creates a rupture inside our core sense of self.  Whatever happened outside gets internalized inside.  So even though the outer trauma ends, the sequelae continue to traumatize the survivor’s inner world, with persecutory inner voices, frightened images, and an overwhelming sense of guilt and shame.  To fully understand this concept, please watch part two of this series:  The inner world of trauma survivors.