Severe and protracted childhood trauma can physically damage the brain’s development, adversely affecting both its structure and functionality, which, in turn, can contribute to the development of very serious psychiatric conditions such as complex posttraumatic stress disorder (complex PTSD) and borderline personality disorder (BPD).
In this article, I will focus in on the main ways in which the brains of individuals suffering from PTSD / Complex PTSD may differ from ‘normal’, non-traumatized brains.
According to the various neuroimaging studies, the brain areas that differ most markedly between these two groups are as follows :
- the hippocampus
- the amygdala
- the prefrontal cortex
Let’s consider each of these three brain regions in turn :
THE HIPPOCAMPUS :
The hippocampus is part of the brain’s limbic system. The limbic system is intimately involved in how our memory functions, our motivation and how we experience emotions such as fear and anger.
It is theorized that it can be damaged by excess cortisol being released into the body in those who suffer severe chronic stress (cortisol is a hormone released into the body under conditions of extreme stress and perceived threat to help mobilize the body and prepare it for ‘fight or flight.’)
Indeed, studies have also shown that the size of the hippocampus is smaller in those suffering from PTSD (however, it should be borne in mind that one cannot categorically infer that this reduction in size has been caused by prolonged exposure to extreme stress – it could be that some people are born with a smaller hippocampus which, in turn, makes them more vulnerable to the adverse effects of stress. Indeed, some research has been carried out that lends this alternative view some weight).
Damage done to the hippocampus by trauma can result in :
- extreme and persistent fearfulness
- problems recalling the traumatic event/s or parts of the traumatic event/s
- constantly intruding, unwanted, distressing and vivid memories of the traumatic event/s
- susceptibility to extreme fear responses in relation to ‘triggers’ (i.e. anything that reminds the traumatized individual of the traumatic event/s on either a conscious or unconscious level)
THE AMYGDALA :
The amygdala is a small part of the brain and its function is to immediately assess whether incoming sensory information (i.e. all the information we take in by sight, hearing, touch, taste and smell) IS A THREAT OR NOT.
So, for example, the amygdala is responsible for making you jump if you hear a sudden, unexpected, loud bang. It operates below the level of our conscious awareness so the responses it gives rise to (like making us jump) are NOT UNDER OUR CONSCIOUS CONTROL.
It works at lightning speed on a ‘better safe than sorry’ basis, so, using the ‘loud, unexpected noise’ example, the sound of the bang will make us jump whether it is the result of dangerous gunfire or a harmless firework.
It is only after this initial, automatic, immediate response (which has evolved in order to be of optimum survival value) that the brain further processes the information to assess whether the noise REALLY DID REPRESENT A THREAT OR NOT.
Because of the amygdala’s function, it is also sometimes referred to as the brain’s FEAR CENTER.
The effect of chronic, severe trauma on the amygdala is that it eventually becomes over-reactive, or, as it is sometimes described, ‘stuck on red alert’, so that we become hypervigilant and may become terrified by people, events, situations etc. that, objectively speaking, pose no threat whatsoever and would not, in the least, cause anxiety in a non-traumatized person. In essence, we start to ‘see threat everywhere’ and may live in a constant state of, at best, apprehension and trepidation.
OTHER EFFECTS OF AN OVERACTIVATED AMYGDALA AND CONSEQUENTLY LIVING IN A STATE OF CONSTANT FEAR :
When we are living in a constant state of fear due to an overactivated amygdala we are essentially locked into the fight/flight survival mode. As such, we become completely focused upon ourselves and selfish, (but it is not a willed, conscious, decision; it is our brain’s way of increasing the chances that we will survive).
This can also result in a much-diminished sense of empathy for others (altruistic and other positive behaviours towards others like forgiveness, generosity and consideration are far more likely to occur when a person feels safe, secure, content and have most of their own needs fulfilled; in relation to this, one need only consider the difference in most people’s behaviour when things are going well compared to when they are going badly).
It should also be noted that the amygdala cannot stay hyperactivated indefinitely which means those suffering from PTSD, at times when the amygdala becomes ‘exhausted’ by its relentless, frenetic activity, will move out of the fight/flight state and move into the ‘freeze’, or dissociated state.
THE PREFRONTAL CORTEX :
In PTSD sufferers, the prefrontal cortex becomes UNDERACTIVATED.
The prefrontal cortex is often described as the THINKING CENTER of the brain and studies involving both humans (including functional imaging studies) and animals suggest that chronic and severe trauma impairs its functioning.
It is theorized that the resulting dysfunction of this brain area impairs its ability to appropriately inhibit the fear-generating amygdala, thus allowing it (i.e. the amygdala) to ‘run riot’, as it were.
Severely traumatized individuals may also experience increased blood flow to the right prefrontal lobe which, in turn, can intensify feelings of sadness and aggression.
Damage done to the brain as a consequence of severe and protracted trauma can result in various cognitive, emotional and behavioural problems in adulthood.
However, 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.
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 :
- NOVELTY– the brain must receive new information and stimuli in order to change itself (e.g. by using repeated self-hypnosis).
- REPETITION– the brain must be repeatedly exposed to this new information to enable it to start making, strengthening and consolidating new neural connections.
- 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)
- DIET– in particular, Omega 3 helps the development of new neural connections (Omega 3 can be bought as a supplement).
- AEROBIC EXERCISE– research suggests that this form of exercise helps the brain to positively regenerate itself
- RELATIONSHIPS – forming close bonds with others (and, importantly, relating well to ourselves) has also been shown to lead to beneficial brain development
- SLEEP – it is important to get sufficient sleep (research suggests that the brain most actively ‘repairs’ itself during sleep.)
David Hosier BSc Hons; MSc; PGDE(FAHE)