Crisis, Trauma, PTSD Exam 1

Things that result in trauma

1 in 5 Americans are sexually molested as a child

1 in 4 children were beaten by a parent to the point of marks being left on their bodies

1 in 3 couples engage in physical violence

1/4 of Americans grew up with alcoholic relatives

1 in 8 children witness their mothers being beaten or hit

Traces of Trauma

History and culture, families, dark secrets passed down through generations, our minds and emotions, capacity for joy and intimacy, and our biology and immune system

Who trauma affects

Those directly exposed, everyone around them, future generations of families, and secondary trauma comes from helping the traumatized victims

How bearable is trauma?

Unbearable

How is energy used after trauma?

Enormous energy to keep functioning while carrying the memory and the shame felt by weakness and vulnerability

Typical initial responses to trauma

Try to push any memories out of their mind and act like nothing happened

3 branches of science that provide knowledge about trauma

Neuroscience, developmental psychopathology, and interpersonal neurobiology

Neuroscience

Study of how the brain supports the mental processes

Developmental psychopathology

Study of the impact of adverse experiences on the development of the mind and the brain

Interpersonal neurobiology

Study of how our behavior influences the emotions, biology, and mindset of those around us

Cascading effects on the family when one person has PTSD, soldier examples

Drinking instead of talking, pushed people away, guilt and anger towards self, and did not want to trust anyone

Changes to the brain from trauma

Medication is technology that changes the way the brain organizes information

Areas of life trauma permeates

Trauma leads to difficulty discerning what is going on, loss of "mental flexibility" and access to imagination, loss of future orientation, and pulled back into the past

Being stuck in trauma

Question where to belong (those who know and those who don't, results in social alienation, event becomes both the source of pain and the sole source of meaning), fundamentally reorganizes the way the mind and brain manage perceptions, how we think and what we think about (as well as our very capacity to think), and the body remains hyper-vigilant in the midst of sharing

Where most human suffering comes from

Crisis

Learned helplessness studies

Opportunity of escape does not equal freedom, secrete stress hormones long after trauma has passed, and seek refuge in the familiar even if it is not safe

Addiction to trauma

Attractors and re-experiencing trauma

Medication

Shut down inappropriate alarm reactions, technology that change the way the brain organizes information, and sole focus on medication may detract from underlying issues

Broca's area

Without a functioning Broca's area, you cannot put your thoughts and feelings into words

Brodmann's area 19

Activation long after the original experience of the trauma, when under normal circumstances, "raw images registered in area 19 are rapidly diffused to other brain areas that interpret the meaning of what has been seen" and "witnessing a brain region rekindled as if the trauma were actually occurring"

Right brain in trauma

"During a trauma, right brain reacts as if the traumatic event were happening in the present, but with the left brain not working well, person may not be aware that they are re-experiencing and reenacting the past - they are just furious, terrified, enraged, ashamed, or frozen"

Left brain in trauma

Deactivation directly impacts the capacity to organize experiences into logical sequences & translate our shifting feelings and perceptions into words (As though "Broca's area black's out during flashbacks)

Critical aspects of the adaptive response

Agency in own rescue and calming of sympathetic nervous system, then able to make sense of event

Basic housekeeping functions of the body that affect psychological problems

Abstract cognition, math/symbolic cognition, performance, modulate reactivity/impulsivity, verbal, and values/beliefs/ morality

Low road

(Down to the amygdala) is extremely fast and will identify if incoming input is relevant for survival and (unconscious, automatic processing, of which we are unaware)

High road

Frontal cortex takes several milliseconds longer in the midst of an overwhelming threatening experiences (conscious, deliberate processing, of which we are aware)

Role of thalamus in trauma response

Sometimes processing can break down in the thalamus, and sight, sounds, smells, and touch are encoded as isolated, dissociated fragments, and normal memory processing disintegrates. Time freezes so that the present dangers feels like it will last forever

Role of amygdala in trauma response

If the amygdala senses a threat, it sends an immediate message to the hypothalamus and the brain stem, recruiting the stress hormone system and autonomic system to orchestrate a whole-body response

Role of deeper regions of the brain in psychological problems

Pressure from deeper regions in the brain that drive our perceptions and attention, rather than not understanding

How disturbances present in children

Act out in a variety of ways (hit, bite, lash out at themselves and others, cling to others one moment and run away the next), all are starving for affection, angry, and defiant, and none can explore or play in ways that are typical for children their age

How we receive lesson of self-care

We get out first lessons in-self care from the way that we are cared for

Types of attachment

Secure, avoidant, ambivalent, disorganized

Secure attachment

A relationship in which an infant obtains both comfort and confidence from the presence of his or her caregiver

Avoidant attachment

Infants who seem unresponsive to the parent when they are present, are usually not distressed when she leaves, and avoid the parent when they return

Anxious-ambivalent attachment

An insecure attachment style characterized by a child's intense distress when reunited with a primary caregiver after separation

disorganized attachment

Characterized by the child's odd behavior when faced with the parent; type of attachment seen most often with kids that are abused

Biological role in attachment

Self-regulation, reliable parents, and responsive caregivers

Roll reversal in the child-parent attachment

Children who do not feel safe in infancy have trouble regulating their moods and emotional responses as they grow older, and the quality of caregiving is critically important in preventing mental health problems

Top-Down Talking Treatment

Connecting with others, understanding what is going on with ourselves, and processing the memories of trauma

Numbing

Limited repertoire of emotions, a sense of disconnection, and likely to only feel intense emotions

Bottom-Up Treatment Experiences

Allowing the body to have experiences that contradict the helplessness and rage that comes with trauma

Higher levels of serotonin

Lessens fear

Lower levels of serotonin

Hyperreactive to stressful stimuli

Reptilian or instinctive brain

The brain stem and hypothalamus region, responsible for fight or flight, hunger, and life sustaining functions

Human or rational brain

Neocortex region, responsible for sensory perception, spatial reasoning, generation of motor commands, conscious thought, intellectual memory, and logic and abstract thought

Mammalian or feeling brain

Limbic system region, responsible for emotions, learning, emotional memory and spirituality

Dissociation

A response to trauma that causes survivors to inhabit their head and lose contact with their body