trauma and the brain

Manic Depression

I’m trying to understand my brain, trying to understand why it has become such a problem. For this reason, I did a search for trauma and the brain. It looks like neuroscientists are just beginning to understand the keys to this subject area. Children subjected to repeated stressful environments DO undergo structural and neurochemical changes in the brain. And, as we’ve said before, if the brain can be injured, it can heal itself, too, through repetition that creates new pathways. This is NOT done by psychopharmacology, which only changes your mix of dopamine, seratonin, norepinephrine, and which stops working the second you stop taking it (leading you to a lifelong dependence on neuro-drugs, and the withdrawal, in my experience has never been taken seriously by doctors, who, as Deborah said, label things as “what lies beneath” (not to mention the fact that these all have the lovely side effects of tremors, zaps, weight gain, baldness, you name it.)

From Traumatized Children: How Trauma Influences Brain Development by Bruce D. Perry

[To help] millions of traumatized children, we need to understand how the brain responds to threat, how it stores traumatic memories and how it is altered by the traumatic experience. Yes, altered. All experience changes the brain – good experiences like piano lessons and bad experiences like living through a tornado as it destroys your home. This is so because the brain is designed to change in response to patterned, repetitive stimulation. And the stimulation associated with fear and trauma changes the brain.

Over the last twenty years, neuroscientists studying the brain have learned how fear and trauma influence the mature brain, and more recently, the developing brain. It is increasingly clear that experience in childhood has relatively more impact on the developing child than experiences later in life. This is due to the simple principles of neurodevelopment.

The functional capabilities of the mature brain develop throughout life, but the vast majority of critical structural and functional organization takes place in childhood. Indeed, by the age of three the brain has reached 90 % of adult size, while the body is still only about 18 % of adult size. By shaping the developing brain, experiences of childhood define the adult. Neurodevelopment is characterized by (1) sequential development and ‘sensitivity’ (the brain “grows” from brainstem to the cortex) and (2) ‘use-dependent’ organization (“use it or lose it”). The mature organization and functional capabilities of brain reflect aspects of the quantity, quality and pattern of the somato-sensory experiences of the first years of life. The sequential and use-dependent properties of brain development result in an amazing adaptive malleability, ensuring that, within its specific genetic potential, an individual’s brain develops capabilities suited for the ‘type’ of environment he or she is raised in. Simply stated, children reflect the world in which they are raised. If that world is characterized by threat, chaos, unpredictability, fear and trauma, the brain will reflect that by altering the development of the neural systems involved in the stress and fear response.

The Neurobiological Responses to Threat

When a child is threatened, various neurophysiological and neuroendocrine responses are initiated. If they persist, there will be ‘use-dependent’ alterations in the key neural systems involved in the stress response. These include the hypothalamic-pituitary-adrenal (HPA) axis. In animal models, chronic activation of the HPA system in response to stress has negative consequences. Chronic activation may “wear out” parts of the body including the hippocampus, a key area involved in memory, cognition and arousal. This may be occurring in traumatized children as well. Dr. Martin Teicher and colleagues have demonstrated hippocampal/limbic abnormalities in a sample of abused children.

Another set of neural systems that become sensitized by repetitive stressful experiences are the catecholamine systems including the dopaminergic and noradrenergic systems. These key neurochemical systems become altered following traumatic stress. The result is a cascade of associated changes in attention, impulse control, sleep, fine motor control and other functions mediated by the catecholamines. As these catecholamines and their target regions (e.g., amygdaloid nuclei) also mediate a variety of other emotional, cognitive and motor functions, sensitization of these systems by repetitive re-experiencing of the trauma leads to dysregulation in many functions. A traumatized child may, therefore, exhibit motor hyperactivity, anxiety, behavioral impulsivity, sleep problems, tachycardia and hypertension. In preliminary studies by our group, we have seen altered cardiovascular regulation (e.g., increased resting heartrate) suggesting altered autonomic regulation at the level of the brainstem. In other studies, clonidine, an alpha2 adrenergic receptor partial agonist has been demonstrated to be an effective pharmacotherapeutic agent, presumably by altering the sensitivity of the noradrenergic systems. Studies by Dr. Michael DeBellis and colleagues have demonstrated other catecholamine and neuroendocrine alterations in a sample of sexually abused girls. These indirect studies all support the hypotheses of a use-dependent alteration in the brainstem catecholamine systems following childhood trauma.

Implications of Trauma-related Alterations in Brain Development

All experiences change the brain – yet not all experiences have equal ‘impact’ on the brain. Because the brain is organizing at such an explosive rate in the first years of life, experiences during this period have more potential to influence the brain – in positive and negative ways. Traumatic experiences and therapeutic experiences impact the same brain and are limited by the same principles of neurophysiology. Traumatic events impact the multiple areas of the brain that respond to the threat. Use-dependent changes in these areas create altered neural systems that influence future functioning. In order to heal (i.e., alter or modify trauma), therapeutic interventions must activate those portions of the brain that have been altered by the trauma. Understanding the persistence of fear-related emotional, behavioral, cognitive and physiological patterns can lead to focused therapeutic experiences that modify those parts of the brain impacted by trauma.

Our evolving understanding of neurodevelopment suggests directions for assessment, intervention and policy. Primary among these is a clear rationale for early identification and aggressive, pro-active interventions that will improve our ability to help traumatized and neglected children. The earlier we intervene, the more likely we will be to preserve and express a child’s potential.

~ by kristenmaybe on December 10, 2008.

2 Responses to “trauma and the brain”

  1. oh did i get into this … sent me to Peter Kramer (The Infinite Mind guy) who blogs on Psychology Today (and claims he received no kickback from big pharma. here’s his latest entry http://blogs.psychologytoday.com/blog/in-practice/200812/no-respect
    When I read his book Against Depression which talked about the holes in the brains of individuals who had been traumatized and over traumatized and over traumatized sans any drug intervention it kinda really made me convinced i had no choice…. i really wanted to post something with links to us here and to the kossaks networking and specifically to yours and mine posts about our therapists but right now i am just so mad. Serequol…. what do you know about seroquol? Now im thinking about beginning the cutback on effexor again slowly, switching to prozac for the final push off and switching to seroquel to get off the ativan and trazadone…

    but in terms of childhood trauma… and activating parts of the brain impacted by trauma … well, it does fit into Kramer’s concepts … only in terms of therapueutic interventions …. ANYTHING BUT DRUGS!

  2. What an enlightening, well written post! Accurate and to the point. As you say, brain structure and function is heavily influenced by our environment. An impoverished, or traumatic environment leading to smaller, poorly connected brain’s, whereas enriched, stimulating environments lead to bigger, richly connected brains. Great post. Loved it.

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