Childhood Trauma And The Brain :
Severe childhood trauma can adversely affect the way in which the brain develops, leading to, for example, extremes in anxiety or great difficulty in controlling emotions. However, there has been exciting research conducted showing that the brain is able, under certain conditions, to ‘rewire’ itself, correcting its own faulty circuitry, and, thus, alleviating the behavioral and emotional problems caused by the original damage.
The adult brain is much more changeable and modifiable than had previously been believed. There is now a large amount of evidence to show that damaged neural (brain) circuitry resulting from severe childhood trauma can be corrected, reshaping our brain anatomy and consequent behavior, with the right kind of therapeutic interventions. In other words, it is now clear that brain architecture continues to change throughout adulthood and this can be manipulated in highly beneficial directions.
Many people who suffer extreme childhood trauma go on to develop personality disorders as adults; one hallmark of these disorders is rigid, destructive behavioural patterns. Research is now showing, however, that certain therapeutic interventions, due to neuroplasticity (the brain’s ability to change itself), can change those behaviours to become more flexible and adaptive (helpful in creating a more successful life).
Another problem those who have suffered extreme childhood trauma develop later on is extreme and obsessive worry which can be so severe it is pathologically categorized as obsessive-compulsive disorder (OCD). For the purposes of explaining how neuroplasticity works, let’s take that (ie OCD) as our example of a problem which needs to be alleviated.
With OCD, obsessive worries can become so extreme that the person experiencing them becomes actively suicidal. Such a tortured state of mind can persist for months or even (as in my own case) years. Indeed, one suicide attempt nearly killed me and I even underwent electroconvulsive therapy (ECT) — to no avail, most regretably (see the ‘My Story’ category if you want to read a bit more about this profoundly distressing period of my life). When anxiety is this pathological, medications may dampen the symptoms somewhat, but, this, of course, fails to address the root psychological cause of the problem.
With this kind of anxiety, terrible and terrifying events are unremittingly anticipated – whether these are largely imagined or not is not the point : the problem is that the threats FEEL real. When something truly appalling is even remotely possible, in the mind of the individual experiencing obsessional anxiety, it FEELS INEVITABLE.
Neuroplasticity-Based Treatment :
In order to address such life-threatening (due to risk of suicide) conditions, the psychologist Jeffrey Schwartz has developed a NEUROPLASTICITY-BASED TREATMENT; it has already yielded excitingly successful results.
To understand his form of treatment, let’s first examine the theory of why those suffering from OCD become mentally fixated on their intense anxieties.
Schwartz, first of all, compared the brains of those who suffered from OCD with the brains of those who did not (by taking scans). After he delivered his form of psychotherapy, he took the scans again which revealed the brains of the patients had normalized.
In ‘normal’ people, when something goes wrong, there is a period of anxiety which gradually wears off. However, with OCD sufferers, the period of anxiety is not only much more intense but also maintains an iron mental grip on the sufferer – the individual becomes ‘stuck’ in this intense anxiety phase. So what is going on in neurological terms?
Schwartz generously enlightened us in the following manner :
1) When something anxiety inducing occurs, a region of the brain, known as the ORBITAL FRONTAL CORTEX, is alerted. Activity in this region of the brain is far greater in those who suffer OCD – it becomes HYPERACTIVE.
2) A chemical message is then sent from that brain region to another brain region – the CINGULATE GYRUS, triggering the anxiety response. IN PEOPLE WITH OCD, the activity here is, again, far more than normally intense. Crucially, too, in people with OCD, the intense activity in this brain region STAYS ‘LOCKED ON’ (as if the ‘ON SWITCH’ which has activated it CANNOT BE ‘SWITCHED OFF’). Indeed, Schwartz referred to this phenomenon as ‘BRAIN LOCK’. (In ‘normal’ individuals the activity in the stimulated brain regions gently fades away, as the brain designed it to do).
The treatment Schwartz developed is designed to ‘UNLOCK’, and normalize, the manner in which the brain’s circuitry works.
THE FIRST STEP in the therapy is for the OCD sufferer to RELABEL what s/he is experiencing AS A SYMPTOM OF HIS/HER OCD. S/he should remind him/herself that it is ‘just’ the neurological malfunctioning (the ‘brainlock’) which is the true cause of his/her discomfort, NOT the content of the anxiety itself. This relabeling provides some mental distance from the content of the obsessive concern. The more the person can concentrate on the physiological reasons for the feeling of distress, and the more s/he can distance her/himself from its actual content, the more effective the therapy tends to be.
Once this has been acknowledged, THE SECOND STEP is to REFOCUS THE ATTENTION ON SOMETHING POSITIVE and, ideally, pleasure-inducing.
As the person gets better at implementing these steps, new brain circuits start to develop : the obsessive circuits begin to be bypassed. Of course, changes do not materialize instantaneously – the brain takes time to ‘rewire’ itself.
If the person finds implementing the above two steps difficult to do, s/he should remind him/herself that even distancing him/herself from the content of the anxiety and doing something pleasurable instead for just one minute will help develop the beneficial new brain circuitry.
Two rather pithy sayings, often quoted by psychologists, help us to remember the theory behind the therapy :
– ‘neurons that fire together, wire together’
– ‘neurons that fire apart, wire apart’
To end this post with an encouraging statistic, it is worth recording that 80% of Schwartz’s patients got better when this therapy was combined with medication.
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David Hosier BSc Hons; MSc; PGDE(FAHE).