Trauma and trigger

Trauma

You're in the middle of the trauma, your heart is beating, the adrenaline is pumping around your body. Everything feels like it has slowed down for you in this moment, like a film being played back in slow motion. In this crisis, this mess, the complete chaos of the moment, you strangely focus away from the danger onto the ticking of the clock - it’s still the same, it’s normal, it’s still ok. Your world is collapsing around you but in this moment you feel strangely in your own anaesthetic bubble with the ticking clock, like the little wooden bird ornament next to it, looking down on this surreal set of events. Suddenly smash! You're back in this crazy, scary moment - the blood, the pain, the scream, the fear, it’s all yours again, all yours to pick up and sort out and oh how this hurts. Fight and flight you survive.

Time goes by, maybe days, weeks even months of not feeling it, not talking about it. It’s easier to move on and shut it out. Then one ordinary simple sunny afternoon, after a long day, you're somewhere else - sitting feeling a little out of place, in an unfamiliar shop that sells antiques. What is it? What is that uncomfortable feeling rising within you? You see people talking, smiling, it should all be ok, but there is a mini volcano erupting right in the heart of you. For a moment you feel yourself pull away from the slow strange chatter chatter and everyone again seems not quite real. And then thud! Here comes the volcano, the sound of that ticking antique clock and you're paralysed, shaking with fear again but this time in the antique shop with those strange normal chatting people who just have not a clue what is going on.

What is happening?

The above scenario is an example of a trigger causing a flashback. This situation may be a painfully common experience for someone experiencing post-traumatic stress disorder (PTSD).

So what has just happened for the person experiencing this? When an event happens the amygdala registers sensations and bodily functions. The amygdala then passes this information onto the hippocampus which makes sense and meaning out of the event. For example, I may feel the pain of putting my hand it scolding hot water - the amygdala immediately registers pain, the hippocampus then makes sense of what happens, which would be to understand that I just put my hand in water too hot. The hippocampus gives meaning and adds context to what has happened. After the hippocampus has made sense of it the event can be stored in the cortex. When a traumatic event happens the hippocampus becomes overcharged and does not record the information in the cortex properly. Instead of the meaning and context being stored properly, explicitly, it gets stored implicitly in the cortex with much feeling but little sense. Going back to what might be happening to you initially in our trauma example above and the ticking clock, it is the hippocampus becoming overcharged and therefore inhibiting you from processing what has happened properly.

Pierre Janet theorised that people who were suffering because of a traumatic event sometimes experienced a loss of ability to retain and draw upon conscious information. The intensity of an experience can cause memories of particular events to dissociate from the conscious and be stored in strong emotional sensations such as deep anxiety or in disturbing images such as flashbacks. These emotions and visions, Janet felt, cause a disruption to the integration of the experience into existing memory.

Re-experiencing and counselling

When a traumatic event happens we have to drastically redefine our existing memory and our internal perception of life. This takes time and causes emotional upheaval and stress. The process of re-experiencing is a way of dealing with this process of redefining. A person may go through the events again and again in their mind in order to try to emotionally make sense of the situation and therefore move onto integrating the experience and redefine their internal perception of life. This can happen in many re-experiencing scenarios, some better than others. Re-experiencing within counselling can provide a safe way to do this. An experienced counsellor can guide and hold an individual, emotionally, while going through this important process, within a safe therapeutic environment.

Merton Gill highlights the importance of re-experiencing. Re-experiencing traumatic and difficult experiences from our past, under therapeutic conditions, can allow a person to heal. It is through the re-experiencing, initiated via a trigger, under safe, trusting conditions, that it’s possible to mentally and emotionally redefine what is going on. Maybe in this therapeutic situation, as well as other positive life connecting situations, our brain, with the help of the hippocampus re-recording, gets a sort of second chance.

Bibliography

• Simington (2013) - 'Trauma and Dissociation: Neurological and Spiritual Perspectives'
• Regal, Joseph (2010) - 'Post-Traumatic Stress: The Facts' (Oxford University Press, Location 509)
• Khan (1991) - 'Between Therapist and Client' (New York: Holt, P59)