What is Psychological Trauma? Doug Bremner October 19, 2014 Childhood Abuse, Psychology, Trauma Chapter One of “You Can’t Just Snap Out Of It” available on amazon here. Get the amazon kindle version free here for a limited time! Trauma occurs when you experience a life-threatening event to yourself or someone close to you, accompanied by intense fear, horror or helplessness (as defined by the American Psychiatric Association). Trauma can leave an indelible imprint on the brain. For example, if you look at the brain scans of some traumatized individuals, you can see shrinkage of brain regions—such as the hippocampus—that are involved in memory, or a failure in brain areas—like the frontal cortex—that are supposed to turn off the fear response. What you can’t see, but what is equally important, is what that trauma does to the survivor’s self-image. How a person feels, how he perceives himself and the world can be dramatically altered after a traumatic experience. Although trauma can wreak havoc on the brain and the psyche of individuals, as we will show in this book, IT DOESN’T HAVE TO. Whether trauma has these devastating effects or not depends on how we deal with it—or more precisely, how we don’t deal with it. One of the things that surprises me most is how poorly many professionals and lay people advise trauma victims. Despite the fact that we now have a large body of research literature on the disease, trauma victims are regularly told to do the opposite of what my research and the research of others shows to be effective. In a variety of ways, victims are told to “just get over it,” to “put it behind them,” to “snap out of it.” As my work demonstrates, you can’t just “get over it” because trauma can change the parts of the brain involved in memory, which can then result in those traumatic memories playing over and over again. As a result of this change, you can’t just stop the memories of your own free will. However, although I know as a researcher that the brain can’t just get over it, as a trauma survivor and a clinician, I know only too well the impulse to tell oneself and others to block it out, to move beyond it. There’s something deeply human about the desire to not face the pain, to believe the old adage “out of sight, out of mind.” Trauma is a Disease Unfortunately, it is this very notion—that we can and should block out traumatic memories—that serves in part to keep the brains of many people caught replaying the memory of the events in an endless cycle. In response to trauma, the heart and mind pull in opposite directions. While the brain endlessly repeats events, the heart is desperately telling the mind to move away, not to go there. The problem with the idea that people should just get over it is that trauma is not a state of mind. It is not an attitude or a belief that needs to be changed. It is a disease, the “I can’t stop thinking about it disease.” You can’t just forget about it, or will it away. Could you will yourself out of diabetes? Or cancer? Of course not. So why would you be able to will yourself out of trauma? It’s not any different. Left alone, trauma won’t heal itself. Trauma is like a virus. Just as a virus leads to disease, trauma can lead to a disease: trauma-related mental and physical symptoms. If you mount an effective immune response to the virus, you won’t get the disease. Some people have good immune systems; others have immune systems that don’t go quite far enough, and in the end they get the disease. Others do not mount any immune response—they may get sick and even die. Like a pathogen, trauma is a trigger that can lead to physical and mental disease if not recognized, dealt with, and addressed. Similar to the immune system’s response to infection by a virus, we have mechanisms within us to deal with trauma…night soldiers waging a secret war, so secret we’re not consciously aware of it. The immune response to trauma is something like that, although it is more mental and cognitive. If your immune system doesn’t kick in to fight an infection, you need help. That’s why we have antibiotics. This book gives you a cognitive, or thinking, antibiotic for the treatment of trauma. It is about what happens when our desire to block out traumatic events is at war with a mind incapable of letting go of the memories. Some trauma survivors will put on “a brave face,” a false persona. On the outside, they are the picture of healthy, successful, mature adults, while on the inside they feel frozen in time, frozen in the grief and the pain of the event. This is a very common psychological response when the trauma is not adequately addressed at the time of the traumatic events. But this is just one possible reaction. People are extremely resourceful, and will look for all kinds of ways to suppress the memory of the traumatic events—from drinking or taking drugs, to working night and day, to having affairs. Sometimes the attempt to suppress the trauma from their thoughts results in damage to the body in the form of heart disease or gastric ulcers. Occasionally, particularly when you are faced with a vivid reminder of the traumatic event, all attempts at suppression fail. This might cause the person to be thrown back to the events in what professionals call “a flashback.” The Key Moment for Me My professional interest in psychological trauma crystallized the first time I was faced with a trauma victim who was in the midst of a flashback. I was a psychiatry resident at Yale University Medical School. It was a humid night in August, and I was on overnight call duty at the Veterans Administration (VA) Hospital in West Haven, Connecticut. I’d just managed to fall into a fitful sleep when the ring of the telephone pulled me back into the world of the living. The operator patched through a veteran who wanted to talk to the psychiatrist on call. “Gotta get them out, gotta get them out,” the voice on the other end of the line said. Click here for the continuation of Chapter One of You Can’t Just Snap Out Of It. Or get it on amazon for kindle and paperback.