Cognitive and Emotional Brain Processing in Trauma Therapy

TreesThe Triune Brain is a useful concept in understanding the interaction between cognitive and emotional brain processing. According to MacLean (1985) the human brain is a 3-part system:

  • The Brain Stem or Reptilian Brain is responsible for activation, arousal, and homeostasis. It’s about regulation.
  • The Limbic System: learning, memory, emotion. It wraps around the reptilian brain. It’s about relating.
  • The Cerebral Cortex: conscious thought, problem solving, self-awareness. Verbal communication. It’s about reason.

Researchers have found is that trauma is processed in the limbic part of the brain—which is wrapped up around the brain stem, the reptilian brain—not the cerebral cortex or the rational part of the brain (Siegel, 2003; van der Kolk, 2014). Together the brain stem and the limbic system form the emotional brain (van der Kolt 2014).

After having experienced trauma, the amygdala in the limbic brain becomes oversensitive to threat activating physiological and emotional responses that replicate the original trauma. These automatic fight/flight/freeze responses, originating from the reptilian brain, create distress in trauma survivors (van der Kolk, 2014).

When a person is traumatized or experiences traumatic stress, problems start to occur in the brain. When the amygdala fires, the cerebral cortex stops working fully or all together (Siegel, 2003; van der Kolk, 2014).  This makes it harder to control emotions and impulses, think, speak or act rationally, or be able to feel the visceral sensations in our body (Payne, Levine, & Crane-Godreau 2015).

Somatic (body-oriented) therapy works with the visceral sensations of the body, thus it’s an effective technique to work through trauma. By starting to connect with the reptilian brain co-regulation begins to occur between the therapist and the client. This it the first step in brain rewiring. The body, the emotions and the thoughts also begin to integrate and the client learns to trust the process.

References

MacLean, P. D. (1985). Brain evolution relating to family, play and the separation call.  Archives of General Psychiatry, 42, 405-417.

Payne, P., Levine, P., & Crane-Godreau. (2015). Somatic experiencing:  Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6(93), 1-18.

Siegel, D. (2003). An interpersonal neurobiology of psychotherapy:  The developing mind and resolution of trauma. In M. Solomon & D. Siegel (Eds.), Healing trauma:  Attachment, mind, body and brain (pp. 1-56). New York: Norton.

van der Kolk, B. (2014). The body keeps the score:  Brain, mind, and body in the healing of trauma. New York: Penguin.

© Maria Stella, PhD. All Rights Reserved.

Cultivating Inner Strength

TreeInner strength is a resource that is invaluable for dealing with the challenges of everyday life and turning them into positive experiences. Cultivating your inner strength, or learning to come to terms with who you are and valuing your contributions to the world is a continual process of growth.

In his book Hardwiring Happiness, Rick Hansen talks about “positive neuroplasticity” or how to use your mind to change your brain, cultivate inner strength by activating positive experiences in your life. If you don’t make use of this power yourself, other forces will shape your brain for you, including pressures at work and home, technology and media, pushy people, and the lingering effects of painful past experiences.

Since we have a negativity bias that looks for problems and dangers, unless we pay mindful attention to positive experiences they will flow through our brains without being acknowledged.

The best way to compensate for the negativity bias is to regularly “take in the good”. This involves four simple steps:

1) Have a positive experience

Notice a positive experience that’s already present in the foreground or background of your awareness, such as a physical pleasure, a sense of determination, or feeling close to someone.

2) Enrich it

Stay with the positive experience for five to 10 seconds or longer. Open to the feelings in it and try to sense it in your body; gently encourage the experience to be more intense, and find something fresh or novel about it.

3) Absorb it

Intend and sense that the experience is sinking into you as you sink into it. Perhaps visualize it sinking into you like water into a sponge—know that it’s becoming a part of you, a resource that you can take with you wherever you go.

4) Link positive and negative material

While having a vivid and stable sense of a positive experience in the foreground of awareness, also be aware of something negative in the background. (Whenever you want, let go of the negative and rest only in the positive). Get a sense of the positive going into the negative: putting it in perspective, soothing it, easing it, and even replacing it – like flowers crowding out and even pulling weeds.

Sometime we have such a strong negative bias that we many need the help of a therapist to support this process of cultivating our inner strength and learning to take in the numerous positive experiences that are often overlooked. For example, if you often feel worried, hurt, or resentful, your therapist can assist you in finding your antidote experiences that would include belonging, self-compassion, friendship, and kindness.

 

Processing Traumatic Grief

Fall TreesGrief and trauma share many aspects including intrusive thoughts, painful and intense emotions, fear of being overwhelmed, efforts to avoid reminders, feelings of hopelessness and guilt, and often reduced family and social support. Traumatic bereavement involves a complex overlay of symptoms that arise from the difficulty in moving on with the grief process due to preoccupation with the trauma and its imagery.

Informing clients about trauma and grief will normalize and understand the often overwhelming, confusing and often conflicting set of experiences in their lives. Counselling sessions may include working with intense feelings and perceptions, trauma treatments leading to trauma mastery, addressing initial tasks of grief and mourning, and finally, trauma and loss accommodation.

According to Ambrose:

The literature on grief and bereavement highlights factors that may result in more prolonged and/or difficult bereavement. These factors include 1) the characteristics of the death; 2) characteristics of the relationship with the deceased person(s); 3) the survivor’s particular vulnerabilities including past mental health; 4) previous life experiences including losses and trauma; 4) support in one’s family and social network after the death; and 5) other crises that may arise in the aftermath of the death.

External or objective factors that influence our reactions and potential long-term outcome include the following: 1) suddenness and lack of anticipation; 2) violence, mutilation and destruction; 3) degree of preventability and/or randomness of the death; 4) multiple deaths (bereavement overload); and 5) mourner’s personal encounter with death involving significant threat to his/her personal survival, or a massive and shocking confrontation with the deaths (and/or mutilation) of others.

If you experience traumatic grief reactions, a counsellor can be a valuable support, not only help you understand what is going on, but also to guide you through the process of healing.

Reference:

Ambrose, J. Traumatic Grief: What We Need to Know as Trauma Responders

Finding Hope after Trauma

BeachPeople who have experienced profound trauma and loss cannot easily feel hopeful about the future. In therapy clients tend to speak repeatedly about their unbearable pain or feel a sense of numbness and apathy. How can a therapist help clients under these circumstances?

We can begin by looking at ways people found solace and support throughout human history: the routine of everyday life. Activities such as appreciating a cup of tea, making dinner for a child, walking on the beach, can assist clients in reconnecting with their inner strength, a sense of agency present despite the pain.

Dolan (2015) explains further:

Strangely enough, the “distraction” of living fully in the present seems to be the only real cure for the terrible things life can do to us, the only real source of hope in hopeless situations. As therapists and healers, we can’t make people feel hopeful, nor can we reverse the tragedies that make them feel hopeless. But we can help them slowly begin building, out of life’s own materials, a place in which hope can nest.

Supporting clients discover how their ancestors coped with their painful emotions and how those activities might currently help them is a good start.

Reference

Dolan, Y. (2015). How Our Everyday Behavior Can Heal Trauma Simple Therapy Techniques that Create Hope. Psychotherapy Netwoker. Retrieved from https://www.psychotherapynetworker.org/daily/posts/trauma/how-our-everyday-habits-can-heal-trauma/

Therapeutic Relationship Rewires Brains

According to Dan Siegel a therapist can help clients increase brain integration through attunement between therapist and clients. The therapist information and experiences offered in session, can rewire clients’ brains in ways that lead to more flexibility, vitality, and intimacy in their lives.

In the following short video Dan Siegel explains this process:

Trauma Treatment: Safety Comes First

Poppies In my approach to trauma therapy I don’t ask clients to recall traumatic memories unless they have learned how to work with anxiety, emotions, feelings and body sensations resulting from those memories.

Once clients have understood and are able to navigate this daunting material, they gain more courage and confidence in their ability to move through and heal the distress of traumatic memories, rather than feeling controlled by them.

As Babette Rothschild (2014) said:

Therapists can know when by watching for physical signals of autonomic system arousal, transmitted by the client’s body, tone of voice, and physical movements. When a client turns pale, breathes in fast, panting breaths, has dilated pupils, and shivers or feels cold, her sympathetic nervous system (activated in states of stress) is aroused. Stress hormones are pouring into her body, threatening the hippocampus with shut-down.

These symptoms mean it’s time to calm the client down. When, on the other hand, a client sighs, breathes more slowly, sobs deeply, sweats, or flushes, her parasympathetic nervous system (activated in states of rest and relaxation) has been activated, and her stress hormone levels are reducing. Recognizing these bodily signals is invaluable to the therapist. Likewise, a client who learns to recognize them often gains a greater sense of body awareness and self-control.

Helping trauma survivors feel safe is particularly helpful in therapy. This process allows for healing to occur in a gentle manner while clients regain trust and confidence in their ability to move on.

Reference

Rothschild, B. (2014). Applying the Brakes In Trauma Treatment, Safety is Essential. Psychotherapy Netwoker. Retrieved from psychotherapynetworker.org/daily/daily/trauma/applying-the-brakes

© Maria Stella, PhD. All Rights Reserved.

Working with Impatience

TurtleImpatience is unpleasant. When will I recover from these layers of grief? When will I stop verbally attacking my spouse? When will I find some peace in life? It’s that irritation fretting at the part where you’re ready to change but for whatever reason you haven’t been able to yet, and there’s little you can do about it. This state of readiness is important when you’re trying to accomplish something; you have to be looking forward to see the goal in front of you. But often impatience stops you from doing the actual work needed to change. How can one works with this irritation? Pema Chodron suggests:

When you’re like a keg of dynamite just about to go off, patience means just slowing down at that point—just pausing—instead of immediately acting on your usual, habitual response. You refrain from acting, you stop talking to yourself, and then you connect with the soft spot. But at the same time you are completely and totally honest with yourself about what you are feeling. You’re not suppressing anything; patience has nothing to do with suppression. In fact, it has everything to do with a gentle, honest relationship with yourself. If you wait and don’t fuel the rage with your thoughts, you can be very honest about the fact that you long for revenge; nevertheless you keep interrupting the torturous story line and stay with the underlying vulnerability. That frustration, that uneasiness and vulnerability, is nothing solid. And yet it is painful to experience. Still, just wait and be patient with your anguish and with the discomfort of it. This means relaxing with that restless, hot energy—knowing that it’s the only way to find peace for ourselves or the world (pp. 37-54).

In this sense working through impatience doesn’t have to mean forgetting about your goals and aspirations, but rather realizing that they’re going to take time. The way to achieve your goals is mindfully slowing down, touching in with your heart, doing the best you can in the here and now, focusing all of your energy and attention on what you’re doing. This process will help you change in the long run.

Reference

Chodron, P. (2006). Practicing Peace in Times of War. Boston: Shambhala.

© Maria Stella, PhD. All Rights Reserved.