Category Archives: Effect Of Trauma On Brain Articles

Neurocounseling And Its Relevance To Treating Complex-PTSD

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The term neurocounseling refers to a form of therapies that seek to take advantage of the relatively recent neuroscientific discovery that the human brain has far more NEUROPLASTICITY than was previously believed to be the case.

What Is Neuroplasticity?

The brain’s quality of neuroplasticity can be defined as its capacity to be physically changed, not only during childhood, but over the whole life-span ; it is only relatively recently that the extent to which the adult brain can be physically altered (both in terms of its structure and its pattern of neuro-pathways) has been discovered.

Why Is The Brain’s Neuroplasticity, And Therefore Neurocounseling, Relevant To The Treatment Of Complex-PTSD Resulting From Childhood Trauma?

Neurocounseling and the phenomenon of neuroplasticity have important implications for the treatment of post traumatic stress disorder (PTSD) and   complex-PTSD as sufferers of both types often have incurred damage to certain brain regions as a result of their traumatic experiences.

These brain injuries can include a shrunken hippocampus ( the hippocampus is a brain region involved in the processing of memories, including differentiation between past and present memories); increased activity in the amygadala ( a region of the brain involved in the processing of emotions and that is intimately related to the fear response); and a shrunken ventromedial prefrontal cortex (this region of the brain processes negative emotions that occur in response to exposure to specific stimuli).

Neurocounseling :

Neurocounseling is founded upon the premise that that symptoms of psychiatric conditions (both psychological and behavioral) are underpinned by maladaptive, neurological structures and functions and that these neurological structures and functions can be beneficial altered due to the quality of the brain known as neuroplasticity. It combines neuroscience with counseling techniques and, in this way, the individual receiving treatment is helped to learn new skills and new ways of thinking in an attempt to help correct the maladaptive physical development of the brain that has occurred in response to the person’s traumatic past experiences. Examples of neurocounseling techniques include :

  • incorporating biofeedback into the treatment plan ; this can help to treat emotional dysregulation – emotional dysregulation is a major symptom of PTSD and complex-PTSD and is linked to damage to the amygdala (see above)
  • incorporating neurofeedback into the treatment plan
  • mindfulness meditation training (one study found that this can alter the actual physical structure of the brain in just eight weeks)

Additionally, studies have shown that interpersonal psychotherapy and compassion focused therapy can lead to beneficial alterations to the brain.

Furthermore, research shows that neurocounseling can also be successfully employed to treat a range of addiction issues (including prevention of relapse and recovery management), sleep difficulties, ADHD, chronic fatigue syndrome and problems relating to aggression (all of which, potentially, can be linked to childhood trauma).

As understanding of the relationship between the way in which the physical brain operates and symptoms of psychological problems increases, it should be possible, in the future, to be apply neurocounseling more effectively to an expanding range of behavioral and psychological difficulties that have their roots in maladaptive brain biochemistry and physiology.

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‘Amygdala Hijack’ And BPD

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One of the main, and most problematic, symptoms that those with borderline personality disorder (BPD) suffer from is the experiencing of disproportionately intense emotional responses when under stress and an inability to control them or efficiently recover and calm down once such tempestuous emotions have been aroused. This very serious symptom of BPD is also often referred to as emotional dysregulation.

The main theory as to why such problems managing emotions occur is that damage has been done to the development of the brain region known as the amygdala in early life due to chronic trauma and, consequently, this area of the brain having been overloaded and overwhelmed by emotions such as fear and anxiety during early development causing a longterm malfunction which can extend well into adulthood or even endure for the BPD sufferer’s entire lifespan (in the absence of effective therapy).

The damage done to the development of the amygdala means that, as adults, when under stress, BPD sufferers are frequently likely to experience what is sometimes referred to as an emotional highjack or, as in the title of this article, an amygdala hijack.

What Is ‘Amygdala Hijack’ And How Does It Prevent Emotional Calm?

When external stimuli are sufficiently stressful, the amygdala ‘shuts down’ the prefrontal cortex (the prefrontal cortex is responsible planning, decision making and intellectual abilities).

In this way, when a certain threshold of stress is passed (and this threshold in far lower in BPD sufferers than the average person’s) the amygdala (responsible for generating emotions, particularly negative emotions such as anxiety, fear and aggression) essentially ‘takes over’ and ‘overrides’ the prefrontal cortex.

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Above : under sufficient stress the prefrontal cortex (the seat of rational thought) is shut down, leaving the amygdala (the seat of intense, negative emotions like anxiety, fear and aggression) to ‘run riot.’

As such, the prefrontal cortex ‘goes offline’ leaving the BPD sufferer flooded with negative emotional responses and unable to reason, by logic or rational thought processes, his/her way out of them.

When the amygdala is ‘highjacked’ in this way, there are three main signs. These are :

1) An intense emotional reaction to the event (or external stimuli)

2) The onset of this intense emotional reaction is sudden

3) It is not until the BPD sufferer has calmed down and the prefrontal cortex comes ‘back online’  (which takes far longer for him/her than it would for the average person) that s/he realizes his/her response (whilst under ‘amygdala highjacking’) was inappropriate, often giving rise to feelings of embarrassment, humiliation, guilt, remorse and regret.

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Early Childhood Trauma : Early Life Neglect Damages Brain

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This article considers the effects of early childhood trauma with a focus on the Romanian Orphan Study.

The Romanian Orphan Study :

This research studied 125 teenagers who lived in (adoptive) loving and stable families BUT had, as infants, had suffered early childhood trauma as they had lived in the NEGLECTFUL ENVIRONMENT of ROMANIAN ORPHANAGES (renowned for their extremely poor conditions).

The Findings :

Using brain scanning technology, it was found that these teenagers had brains which contained LESS WHITE MATTER than the brains of a comparison group of comparable teenagers who lived in similar family environments BUT HAD NOT LIVED IN ROMANIAN ORPHANAGES AS INFANTS.

The brain’s white matter is involved in learning and facilitates the communication between different brain regions ; it is located deep within the brain. (Its volume can also be depleted as a result of excessive use of alcohol and aging.)

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Above : Brain scans showing anatomical differences between the brain of a normal three-year-old and that of a three-year-old who has experienced early childhood trauma (extreme neglect).

Deprivation :

It is suggests that the SENSORY DEPRIVATION that the teenagers experienced as infants in the appalling conditions in which they were kept (‘caretakers’ worked in factory- like shifts and the infants might have up to 17 such carers each week, thus depriving them of sustained, one-to-one, loving contact), anatomically, adversely affected brain regions involved in :

– cognitive processing

– attention

– emotional processing

Specifically, Which Brain Regions Were Damaged?

PET scans (PET scans – or positron emission topography scans – are a type of brain scan) revealed that the main regions of the brain that were damaged by this early life neglect and deprivation were :

– the amygdala

– parts of the hippocampus

– the brain stem

– parts of the prefrontal cortex

– the orbital frontal gyrus

The PET scan revealed that all of the above brain regions had abnormal activity in the teenagers who had lived in the Romanian orphanage during their early lives compared to the comparison group of teenagers.

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Seven Key Elements That Aid Brain Repair

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REPAIRING THE BRAIN :

We have seen from several other articles that I have published on this site how significant childhood trauma can adversely affect the physical development of the brain which, in turn, can result in various cognitive, emotional and behavioural problems in adulthood.

However, we have also seen, thanks to a quality in the brain known as neuroplasticity, that it is now known that, under certain conditions, the brain has the potential to recover from the damage it incurred during early life.

For example, if our brain was affected in such a way when we were young that, as adults, we are extremely anxious and hypersensitive to stress, mindfulness meditation has been shown by much research to have the potential to greatly alleviate this problem.

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In order for positive changes to take place in the brain that are long-lasting, it is necessary to alter the structure of the brain on a neuronal level; seven major elements that are of great importance to achieving this are as follows :

REPAIRING THE BRAIN : THE SEVEN KEY ELEMENTS 

  1. NOVELTY – the brain must receive new information and stimuli in order to change itself
  2. REPETITION – the brain must be repeatedly exposed to this new information to enable it to start making, strengthening and consolidating new neural connections.
  3. ATTENTION – it is necessary to pay good attention to the new information/stimuli for the new, beneficial neural connections to occur (paying attention stimulates the production of acetylcholine in the brain which aids the development of these new neural connections)
  4. DIET – in particular, Omega 3 helps the development of new neural connections (Omega 3 can be bought as a supplement).
  5. AEROBIC EXERCISE – research suggests that this form of exercise helps the brain to positively regenerate itself
  6. RELATIONSHIPS – forming close bonds with others (and, importantly, relating well to ourselves) has also been shown to lead to beneficial brain development
  7. SLEEP – it is important to get sufficient sleep (research suggests that the brain most actively ‘repairs’ itself during sleep).

 

Repeated self-hypnosis can also be used to positively alter the brain 

 

 

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Early Trauma Can ‘Shut Down’ Prefrontal Cortex

THE PREFRONTAL CORTEX :

First, I will describe the main functions of the brain’s prefrontal cortex ; they are as follows :

  • modulates feelings of fear associated with threat (eg calms us down if a raised alarm turns out to be a false alarm)
  • controls the intensity of our emotions (so we are neither inappropriately under-emotionally aroused nor inappropriately over-emotionally aroused)
  • helps us to plan and control impulsive, ‘knee-jerk’ reactions
  • helps us to become mentally attuned to others and to empathize with them
  • provides us with a moral awareness and ethical framework
  • provides us with insight into the workings of our own minds
  • helps us behave rationally
  • helps us to think logically
  • helps us maintain a healthy balance between hyperarousal (too much arousal) and hypoarousal (too little arousal).

 

How Early Trauma Adversely Affects The Development Of The Prefrontal Cortex :

Even in emotionally and mentally ‘healthy’ individuals, the prefrontal cortex does not become fully developed until the age of about 25 years; this is a major reason why the behaviour of someone aged, say, eighteen, is often more erratic and ill-considered than that of a person aged, for example, twenty-six years. (It follows from this that a strong argument can be put forward that courts of law should take into account the underdevelopment of the prefrontal cortex in younger adults when considering sentences for this age group.)

Also, crucially, the development of the prefrontal cortex is particularly sensitive to the emotional and psychological environment in which we grow up.

Indeed, if one has suffered severe trauma when growing up, the prefrontal cortex (specifically, the ventromedial prefrontal cortex)  may not physically develop to its usual size  and, therefore, in adulthood, be of a smaller volume than average.

This can inhibit the functions listed above to varying degrees (depending upon the degree to which the development of the brain region has been damaged). In particular, the individual affected in this way may develop hypersensitivity to stressful stimuli, an inability to calm him/herself down when experiencing stress (sometimes described by psychologists as an inability to self-regulate emotions) and abnormally high levels of fear and anxiety.

Extreme fear responses and high levels of anxiety are particularly likely to occur when an individual who has incurred damage to the prefrontal cortex due to childhood trauma experiences a stressful event or situation which triggers memories (on either a conscious or unconscious level) of the childhood trauma.

HOPE OFFERED BY NEUROPLASTICITY :

However, there is hope for people who have been affected in this way due to a quality of the brain known as ‘neuroplasticity which allows the brain to repair itself. You can read about this in my article  Mending The Mind With Self-Directed Neuroplasticity.

 

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Physical Differences In Narcissists’ Brains

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I have written elsewhere on this site articles about how being brought up by a narcissistic parent can be extremely traumatic for a child and can have life-long adverse effects on his/her emotional and behavioural functioning in the absence of effective therapeutic intervention.

I will quickly recap the list of the main symptoms of the disorder below :

THE SYMPTOMS OF NARCISSISTIC PERSONALITY DISORDER :

– expect to be recognized as superior (even without any achievements to warrant this)

– exaggerated sense of own importance

– a tendency to exaggerate their achievements and talents

– belief of only being able to be understood by equally special people

– obsessed by fantasies of power/success/brilliance

– strong need to be constantly admired by others

– constant sense of entitlement

– expectation to be granted special favors

– expectations to always have wishes complied with by others

– exploitation of others for own ends

– unable or unwilling to acknowledge the needs of others / the feelings of others (lack of empathy)

– frequent envy of others

– frequent beliefs of being envied by others

– behaving in a high-handed, superior, arrogant and haughty manner

(Above list of symptoms adapted from the Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition, otherwise known as DSM -V).

 

WHAT ARE THE PHYSICAL BRAIN DIFFERENCES IN THOSE SUFFERING FROM NARCISSISTIC PERSONALITY DISORDER?

 

A study conducted by Ropke et al examined 34 individuals, 17 of whom had an official diagnosis of narcissistic personality disorder; these 17 individuals had also, through testing, been found to be deficient in feelings of empathy (a main symptom of narcissistic personality disorder – see list of symptoms above).

Using a brain scanning technique known as magnetic resonance imaging (MRI) it was found that the 17 individuals who had been diagnosed with narcissistic personality disorder had differences in the structure of a region of the brain called the cerebral cortex compared to the individuals in the control group (i.e. the individuals in the study who had NOT been diagnosed with narcissistic personality disorder).

 

WHAT WERE THE SPECIFIC BRAIN DIFFERENCES FOUND BY THE STUDY?

Specifically, the MRI scan revealed that those who had been diagnosed with narcissistic personality disorder had cerebral cortices (plural of cortex) that were thinner in the region responsible for producing feelings of compassion for others (known as the insular region) than the cerebral cortices of those in the control group.

This finding emphasizes the fact that those with narcissistic personality disorder require treatment rather than moral judgment.

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Effect Of Childhood Trauma On The Limbic System

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If we have suffered severe and chronic childhood trauma, there is a risk that an area of our brain called the limbic system may have incurred developmental damage which severely affects how we feel and behave as adults.

What Is The Limbic System’s Normal Function?

The limbic system is a region of our brain that experiences emotional reactions to information relayed by our five senses : taste, touch, vision, smell and hearing. These emotional reactions are strongly shaped by the memories stored in the limbic system connected to past experiences associated with these senses.

To provide a simple example : if our ancestors heard the roar of a lion behind them, because this sound is associated (from past experience) in the limbic system with danger, they would react with fear and run away. This function of the limbic system clearly has survival value, which is why modern day humans have inherited it.

Components Of The Limbic System:

The limbic system comprises :

– the amygdala

– the hippocampus

– mammillary body

– hypothalamus

– olfactory cortex

– thalamus

– cingulate gyrus

– fornix

The positioning in the brain of the above regions is shown in the diagram below:

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How Can The Experience Of Childhood Trauma Cause The Limbic System To Become Dysfunctional?

If as children, our limbic system was repeatedly activated by threatening and frightening experiences then its development may have been disrupted. This may mean that it becomes HYPERSENSITIVE to perceived threat AND OVER- REACTIVE to perceived threat.

Importantly, the limbic system may cause us to OVER-REACT TO PERCEIVED THREATS THAT WE ONLY PERCEIVE ON AN UNCONSCIOUS LEVEL. For example, if someone in authority speaks to us in a manner that, on an unconscious level, reminds us of how an abusive parent used to speak to us, we might become extremely anxious, frightened or aggressive (aggression here would represent an unconscious drive to defend ourselves).

Theoretical Reversibility:

However, because of a quality of the brain known as neuroplasticity, this disrupted part of the brain can begin to heal itself through factors including the avoidance of excessive stress, strong and reliable emotional support, self-compassion, a safe and stable environment, and, research has shown, the practice of mindfulness meditation.

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

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How Hypnosis Changes The Brain

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We have seen from many of the articles that I have previously published on this site that significant childhood trauma can actually physically damage the developing human brain; in particular, it can adversely affect the development of a brain area called the amygdala, which is involved in emotional processing.

However, we have also seen that, because it is now known the brain can change itself in positive ways when we are adults (due to a property of the brain known as neuroplasticity), this damage can be reversed.

The use of mindfulness meditation has been shown in research to help the brain recovery from the physical damage done to it in childhood, and, now, recent research has shown hypnosis, too, can change the way in which the brain works and in a manner that can be detected through the use of brain scans / brain imaging.

 

HOW HYPNOSIS CHANGES THE BRAIN:

Kosslyn, a researcher from Harvard University, USA, carried out an experiment on colour perception which involved eight participants.

Each participant was shown brightly coloured rectangles and, under hypnosis, instructed to imagine the colour ‘draining’ from them. This resulted in brain activity that caused them to pereive the brightly coloured blocks as gray.

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The reverse was also true; when instructed, under hypnosis, to ‘see’ gray blocks as brightly colored, they did indeed, due to the change in brain activity caused by hypnosis, perceive the (in reality, gray) blocks as colored.

(For those who are interested, the brain activity of the participants was measured by employing the use of PET [positron emission tomography] scans.

It is also highly important to note that when the participants were asked to perceive these color changes taking place but were NOT under hypnosis, the same changes in brain activity and color perception did NOT occur: this demonstrates that hypnosis used in the experiment was having a very real, measurable and observable (via brain scanning) effect.

This effect is thought to work, Kosslyn explains, because under hypnosis the brain’s right hemisphere, which deals with, amongst other imagination and expectations, is ACTIVATED (whereas the left hemisphere of the brain, dominant when the individual is not under hypnosis, operates more according to logic).

Kosslyn suggests that it might very well be the ability of hypnosis to activate the right hemisphere of the brain that also lies behind the success that hypnotherapy can have when it is used to treat problems such as insomnia, anxiety, pain management and other difficulties in which a person’s psychology plays a pivotal role.
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David Hosier BSc Hons; MSc; PGDE(FAHE).

 

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Three Critical Brain Regions Harmed By Childhood Trauma

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Three critical brain regions that may be adversely affected by significant and chronic childhood trauma are :

1) The thalamus

2) The amygdala

3) The hippocampus

Below, I will briefly describe the main functions of each of these three crucial regions of the brain, together with providing a summary of the damage they may sustain to their development due early adverse experiences.

1) Possible Adverse Effects Of Childhood Trauma On The Development Of The Thalamus :

The thalamus is the part of the brain that assesses all incoming sensory data (ie. information from sound, vision, touch,  smell and taste) and then sends this information on to the appropriate, higher region of the brain for further analysis.

If a child constantly experiences trauma (for example, by frequently witnessing domestic violence perpetrated by a drunken father) the child’s thalamus can become so overwhelmed by the intensity and quantity of sense data it needs to process that it is no longer able to process it properly.

This can lead to the child’s memories of trauma becoming very fragmented.

Another effect of the thalamus being overloaded with traumatic sensory data is to shut down the cortex, resulting in impairment of rational thinking processes. Also, due to the shutting down of the cortex, many of the traumatic experiences are stored without awareness (so that they become unconscious memories).

 

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Above : diagram showing the position of the thalamus, amygdala and hippocampus (together with other brain regions).

 

2) Possible Adverse Effects Of Childhood Trauma On The Development Of The Amygdala :

The amygdala is the brain region that responds to fear, threat and danger.

If a child experiences frequent fear due to childhood abuse the amygdala becomes overwhelmed by the need to process too much information. This can damage it in two main ways :

a) the amygdala becomes overactive and remains constantly ‘stuck on red alert’, leading the individual feeling constantly anxious and fearful, even at times when there is no need to feel this way, objectively speaking. An oversensitive amygdala is also thought to be a major feature of borderline personality disorder (BPD) is a serious psychiatric condition.

b) the amygdala shuts down as a way of protecting the individual from intolerable feelings of being in danger, which can have the effect of leaving the him/her feeling numb, empty, emotionally dead and dissociated.

3)  Possible Adverse Effects Of Childhood Trauma On The Development Of The Hippocampus:

The hippocampus is the part of the brain responsible for long-term storage of memories. If trauma is severe, the consequential production by the body of stress hormones can have a toxic effect upon this brain area, reducing its capacity by as much as 25℅.

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Brain Areas That May Be Adversely Affected By Childhood Trauma

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We have already seen in other posts that I have published on this site that, if we have been unfortunate enough to have been subjected to severe and chronic childhood trauma, it is possible that this adversely affected how our brain physically developed during our early life.

And, if we have been particularly unlucky, this disrupted brain development could have made us highly susceptible to developing borderline personality disorder (BPD) in our adult lives.

 

Indeed, research involving brain scans suggest that sufferers of BPD can have abnormalities in the following brain areas :

– prefrontal cortex

– anterior cingulate

– medial frontal cortex

– subgenual cingulate

– ventral striatum

– ventromedial prefrontal cortex

– amygdala

 

Below : Brain Areas Which May Have Had Their Physical Development Adversely Affected By Our Traumatic Childhood Experiences, Particularly If We Have Developed Borderline Personality Disorder ( BPD) :

Borderline Personality Disorder BPD Abnormal Brain Structures - Brain Areas That May Be Adversely Affected By Childhood Trauma

 

What Are These Brain Areas Associated With?

The function of these brain areas are described below:

PREFRONTAL CORTEX:

– decision making

– conscious control of social behaviour

– speech / writing

– logic

– purposeful (as opposed to instinctual) behaviour

– planning for the future

– expression of the personality

ANTERIOR CINGULATE :

– decision making

– heart rate

– blood pressure

– impulse control

– emotions

MEDIAL PREFRONTAL CORTEX:

– decision making

– memory

SUBGENUAL CINGULATE :

– sleep

– appetite

– anxiety

– mood

– memory

– self esteem

– transporting serotonin

– our experience of depression

VENTRAL STRIATUM :

– decision making

– emotional regulation (the control of emotios)

– the extinction of conditioned responses

AMYGDALA :

– appetite

– emotion

– emotional content of memories

– fear

The Effects Of Disruption Of The Above Brain Areas :

Poor decision making ; poor control of social behaviour ; impaired ability to think rationally ; poor planning for the future ; dysfunctional personality ; increased physiological response to stress ; poor impulse control ; poor emotional control ; insomnia ; changes in appetite ; severe anxiety ; mood instability ; low self-esteem ; impairment of the brain’s ablity to make effective use of serotonin leading to clinical depression ; changes in appetite ; emotionally charged memories leading to flashbacks, nightmares, intrusive thoughts, panic attacks ; feelings of being under constant threat, fear, terror and extreme vulnerability.

Two types of therapy that may be useful are cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT).

Resources :

General Information :

NHS information about borderline personality disorder (BPD). Click here.

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