Trauma And Emotional Relearning
I thought I would add some things I found in the book "Emotional Intelligence" by Daniel Goleman" since I am currently reading it and found some of the research he describes interesting. Chapter 13 specifically focuses on PTSD and the neurological changes created by trauma.
Horror Frozen In Memory
"...PTSD represents a perilous lowering of the neural setpoint for alarm, leaving the person to react to life's ordinary moments as though they were emergencies. The hijacking circut discussed in Chapter 2 seems critical in leaving such a powerful brand on memory: the more brutal, shocking, and horrendous the events that trigger the amygdala hijacking the more indelible the memory. The neural basis for these memories appears to be a sweeping alteration in the chemistry of the brain set in motion by a single instance of wverwhelming terror. While the PTSD findings are typically based on the impact of a single episode, similar results can come from cruelties inflicted over a period of years, as is the case with children who are sexually, physically, or emotionally abused.
The most detailed work on these brain changes is being done at the National Center for Post-Traumatic Stress Disorder, a network of research sites based at Veteran's Administration hospitals where there are large pools of those who sufer from PTSD among the veterans of Vietnam and other wars. It is from studies on vets such as these that most of our knowledge of PTSD has come. But these insights apply as well to children who have suffered severe emotional trauma, such as those (who have witnessed a school shooting).
'Victims of a devistating trauma may bever be the same biologically' Dr Dennis Charney told me. A Yale Psychiatrist, Charney is director of clinical neuroscience at the National Center....
PTSD As A Limbic Disorder
..."The main symptoms of such fearfulness - including the most intense kind, PTSD - can be accounted for by the changes in the limbic circuitry focusing on the amygdala. Some of the key changes are in the locus ceruleus, a structure that regulates the brain's secretion of two substances called catecholamines: adrenaline and noradrenaline. These neurochemicals mobilize the body for an emergency; the same catecholamine surge stamps memories with special strength. In PTSD this system becomes hyperactive, secreating extra-large doses of these brain chemicals in response to situations that hold lttle or no threat but somehow are reminders of the origional trauma....
The locus ceruleus and the amaygdala are closely linked, along with other limbic structures such as the hippocampus and nypothalamus; the circuitry thought to underlie PTSD symptoms, which include anxiety, fear, hypervigialace, being easily upset and aroused, readiness for fight or flight, and the indelible encoding of intense emotional memories. Vietnam vets with PTSD, one study found, had 40% fewer catecholamine-stopping receptors than did men without the symptoms - suggesting that their brains had undergone a lasting change, with their catecholamine secretion poorly controlled.
Other changes occur in the circuit linking the limbic brain with teh pituitary gland, which regulates release of CRF, the main stress hormone the body secretes to mobilize the emergency fight-or-flight response. The changes lead this hormone to be oversecreted - particularly in the amygdala, hippocampus, and locus ceruleus - alerting the body for an emergency that is not there in reality.
As Dr Charles Nemeroff, a Duke University psychiatrist, told me, "Too much CRF makes you overreact. For example, if you're a Vietnam vet with PTSD and a car backfires at the mall parking lot, it is the triggering of CRF that floods you with the same feelings as the original trauma: you start sweating, you're scared, you have chills and the shakes, you may have flashbacks. In people who hypersecrete CRF, the startle response is overactive... (more examples)
A third set of changes occurs in the brain's opiod system, which secretes endorphines to blunt the feeling of pain. It also becomes hyperactive. This neural circuit again involves the amygdala, this time in concert with a region in the cerebral cortex. The opiods are brain chemicals that are powerful numbing agents, like opium and other narcotics that are chemical cousins. When experienceing high levels of opiods ("the brain's own morphine") people have a hightened tolerance for pain - an effect that has been noticed by battlefield surgeons who found severely wounded soldiers needed lower doses of narcotics to handle thier pain than did civilians with far less serious injuries.
Something similar seems to occur in PTSD. Endorphin changes add a new dimension to the neural mix by reexposure to the trauma: a numbing of certian feelings. This appears to explaina set of "negative" psychological symptoms long noted in PTSD: anhedonia (the inability to feel pleasure) and a general emotional numbness, a sense of being cut off from life or from concern about others' feelings. Those close to such people may experience this indifference as a lack of empathy. Another possible effect may be dissasociation, includiong the inabillity to remember crutial minutes, hours, ore even days of the traumatic event.
The neural changes of PTSD also seem to make a person more suseptible to further traumatizing. A number of studies with animals have found that when they were exposed even to mond stress wehn young, they were far more vulnerable than unstressed animals to trauma-induced brain changes later in life (suggesting the urgent need to treat children with PTSD). This seems a reason that, exposed to the same catastrophe, one person goes on to develop PTSD and anoter does not: the amygdala is primed to find danger and when life presents it once again with real danger, its alarm rises to a higher pitch.
All these neural changer offer short-term advantages for dealing with the grim and dire emergencies that prompt them. Under duress, it is adaptive to be highly vigilant, aroused, ready for anything, impervious to pain, the body primed for sustained physical demands, and - for the moment - indifferent to what might otherwise be intensely disturbing events. These short-term advvantages, howerver, become lasting problems when the brain changes so that they become predispositions, like a car stuck in perpetual high gear. When the amygdala nd its connected brain regions tanke on a new setpoint during a moment of intense trauma, this change in excitability - this hightened readiness to trigger a neural hijacking - means all of life is on the verge of becoming an emergency, and even an innocent moment is suceptible to an explosion of fear run amok."