A brief neuropsychology of PTSD

When you've suffered trauma and as a consequence suffer from post traumatic stress disorder (PTSD). What is happening to your body and mind? How might you go about creating necessary changes to gain power over presenting symptoms? This article sets out, in brief, to explain some of these things so that you may go forward with a better understanding of what is happening.

It can be extremely beneficial to know that you are not going mad and to know that what is happening in your body is a traumatic replay of previous events, they are in the past and it is important to realise they are not happening now. The mind can trick us with feelings as if they are real and being re-experienced now but those feelings are set in the past and in this vein are not happening in the present. It may useful to notice your external reality, to sense what's around you, sounds, sights and to focus on deep breathing, grounding and being present. Emotional regulation and psychoeducation around these issues can be facilitated by the therapist and acquired and learnt by you.

If you've suffered abuse, or have been psychologically threatened with other traumatic experiences. It is highly likely that at that time your body did one of three things, which we know are called; fight, flight or freeze responses. These responses are entwined in our neuropsychological systems and with trauma the areas of the brain most responsible for this are the hippocampus and amygydala.

You could think of the hippocampus as the memories personal bank, it stores normal sequential memories which are categorised and organised, you have control over them. It helps us process memories and to contextualise them in history and time. The hippocampus is connected to the amygdala.

In response to a traumatic event/s. The amygdala responds, this is the bodies alarm system releasing stress hormones and powerful neurotransmitters such as cortisol, adrenaline and noradrenaline. It instigates your bodies flight, fright and freeze response. In order for the body to engage quickly the hippocampus shuts down or goes offline. In this vein in extreme stress, information is not stored in the same way and a traumatic memory is stored.

Traumatic memories are different to normal memories in that they are fragmented and disorganised and you have little control over the retrieval of them which means they can occur without warning and in response to various cues or 'triggers'. When they occur it is as if they are happening now. When they come back they often bring with them the same emotions, sensations and experiences that occurred at the same time as the trauma.

Your brain is attempting to re-process these memories and put them back into the filing cabinet. This may feel overwhelming, debilitating and seem incredibly hard to regulate. But you can learn how to change these responses. 

In short,

Counselling for trauma can help with regulating these experiences so that you may gain a better sense of control and mastery over them. When you've suffered traumatic abuse at an early age from significant others or care givers and your psychological safety was threatened. Your ability to regulate your emotions had been thwarted. Significant others and care givers inadvertently act as an internal sounding board for your ability to internalise and model ways of coping and managing thoughts and feelings

In abuse situations you were powerless, not in control, you did the best you could in a situation where your power was taken from you. An important aspect of trauma work is to facilitate your ability to regulate and take control of emotions, thoughts and triggers. There are many ways this can be taught with integrative, psycho-educational approaches in therapy. Psycho-education may involve facilitating a better understanding and awareness of traumatic memories, PTSD symptoms, and various dynamics involved in traumatic experiences.

Body orientated and creative, narrative approaches can help too. As well as a good therapeutic relationship. In many ways, it is an unlearning of learning, in a safe, supportive, empathic environment and one which embodies hope through reflecting strengths and resources.