neuroscience of emotional trauma

[Wraitchel]

I've been thinking about the difficulty of making a person understand why an emotionally traumatic event leaves such lasting scars. I want to help those who do not understand it emotionally understand it scientifically.

When we find ourselves in a terrifying or otherwise powerfully negative emotional state (disgust, rage, powerlessness...), our limbic systems kick in and trigger our sympathetic nervous system to run or fight. Our limbic system also remembers. The thing is, it is not conscious memory being stored. It is positive or negative associations which automatically trigger a physiological response to the same set of triggers later in time. The emotional responses are similarly hard wired and primitive/unconscious. That is why a combat veteran reacts so violently to sudden loud noises. He doesn't have to think about it. Even if he consciously ties to control it, his body is going to break out in sweat, his pupils dilate, his heart races. He feels pure terror. His limbic system has interpreted the loud noise for him and reacted with the fight or flight response, plus all the emotional responses of the original experience.

A victim of rape or other violence feels similarly powerful negative feelings. The limbic system codes sensory information from that event so that when we again find ourselves facing some of those triggers, there is an unconscious response of emotions and physiological events.

Of course it takes years to recover. Those primitive neural connections are not easy to re-route. Over time, the limbic system may be re-wired to associate the sight of a penis with a positive physiological and emotional response. I don't know. After almost three decades, and many good experiences with penises, I still have a mixed reaction to that first glimpse as it emerges from the pants.

"Within the Limbic System of the brain are two related areas that are central in memory storage: the hippocampus and the amygdala. The last few years have produced a growing body of research that indicates these two parts of the brain are essentially involved in response to, and memory of, traumatic events. (van der Kolk 1994, Nadel & Jacobs 1996) It is believed that the amygdala stores highly charged emotional memories, such as terror and horror and it has been shown that the amygdala becomes very active when there is a traumatic threat. The hippocampus, on the other hand, stores memory of time and space - puts our memories into their proper perspective and place in our life's time line. During traumatic threat, it has been shown, the hippocampus becomes suppressed. Its usual function of placing a memory into the past is not active. The traumatic event is prevented from becoming a memory in the past, causing it to seem to float in time, often invading the present. It is this mechanism that is behind the aforementioned PTSD symptom of "flashback" - episodes of reliving the trauma." from http://www.ptsdsupport.net/ptsd_diagnosis.html

I'm not saying that a nonviolent statutory rape is as intensely traumatic as a violent rape or combat stress. I'm just saying that the same physiological processes take over. That's why the effect is so persistent and resistant to reason.

I'm hoping our resident Squid can add to the science here. I am no neurologist.

[Kylyssa]

I don't know. After almost three decades, and many good experiences with penises, I still have a mixed reaction to that first glimpse as it emerges from the pants.

I consciously decided that my "revenge" would be to take great joy in sex.  People tried to pervert sex by forcing it upon me so my desire is to elevate it to the heights of beauty and pleasure.  Maybe it is because of this decision, but the penis itself is to me completely non-threatening and rather delightful.

For me, it is aggressive or aggressive seeming gestures, body postures or sounds which can trigger the memories in a sudden tangle.  Additionally, stress plus a particular smell or situation can do the same.  

It requires systematic desensitization to neuter traumatic memories.  By doing what we do to create regular memories - repeating a two dimensional "story" of what happened to ourselves we can (theoretically) change these full sensory memories into simple memories.  Going over the events in a safe situation can eventually accomplish this.

However, our natural response is to deny and suppress the memories, to set them aside in a bubble where they only consciously impact our lives when the bubble bursts.  Another natural reaction is depersonalization.  Neither of these coping mechanisms provides a permanent solution.

Frankly, becoming sensitized to dangerous situations (or dangerous "feeling" situations) is a survival tactic.  What helped our ancestors to survive is biting us in the foot.  Just like instinctual eating behaviors which helped our ancestors survive through times of famine can lead to obesity these responses to danger can harm us more than help us now.  Strategies that help keep a creature alive long enough to reproduce and raise the optimum number of offspring aren't necessarily strategies for optimum mental health.  Genes don't "care" about how happy their bearers are.

That said, all of the logical understanding in the world cannot armor one against hard-wired responses.

[SSY]

If it was a statutory rape ( I assume there is no forcing involved, simply defined as rape because the underage party/ies is legally unable to give consent ) why would a fight or flight response be triggered at all? This would not presumably be perceived as a threatening situation, merely a sexual one, our bodies would have no conception of the minutae of the laws they are breaking.

[Wraitchel]

I think what you need to realize about statutory rape is that even if it is not a violent brute force attack, if a man coerces and manipulates a virgin into submitting to sex when she really does not want to, it can be an intensely horrifying experience. She may feel disgust, guilt, rage (in part at herself), fear, and sorrow.

I realize that some teens are hot and ready to go with peers or older people, but many are physiologically and psychologically still children. It is far safer to assume that anyone under the age of 18 is too young, unless that make it extremely clear that they are ready and willing. I think it is very dangerous to assume that 16 year old girls, in general, want sex. Read a Seventeen magazine to understand where they get their notions about sexy clothes and attractive behavior. They are trying it on like clothes in a dress-up box.

As for the girl in the initial post in the pedophile thread, read the linked article and tell me if you really think she wanted to have sex with this man.

[Squid]

The description from the website is a decent, albeit very simple, place to start.  Over the years of research into PTSD it has been found that it is far more complicated than simple memory of bad events replaying - a sort of haywire evolutionary system to help us survive.  There's the complex neurobiology of the subsystems of the limbic lobe and it's interaction with the prefrontal cortex as well as specific receptor proteins and sites within those structures along with psychological associative learning and, of course, subsequent endocrinological involvement.  There has been a proposal that two subtypes exist which has been substantiated by neuroimaging - one is marked by hyperarousal and one by dissociation, each with their own separate pathways.  Some research proposes that PTSD imposes sleep disturbances which compound the problems themselves.  Also, specific genes have been linked to PTSD or rather the possible susceptibility for someone to suffer from it which seems intuitive since not all people who experience trauma suffer long term ill effects and therefore some people may be more vulnerable than others.  And there's the stimulation of the HPA axis on a chronic timetable which leads to the production of more problems such as elevated risk of infection from immune suppression, vascular problems, elevated risk of depression and other disorders amongst a whole laundry list of other possibilities.

Only in the last, say, nearly 20 years has there been a real push to understand PTSD and how to successfully treat it.  Unfortunately, nature has a good long start ahead of us so we need a lot of time to play catch up.  There is no doubt, however, that changes do occur and persist long after the traumatic event and some evidence shows these changes may be permanent (that is we current lack the knowledge of how to "reverse" or "undo" what changes biologically) and therefore we attempt to treat the symptoms through counseling, behavior modification, cognitive therapy and medication.

If anyone is looking for a detailed look into the biology underlying PTSD, there's plenty of resources on the net - just ask the almight Google...but there's also a lot of crap.  The best way to really keep abreast of the research is to read the literature and a PubMed or Google Scholar search can lead you to some salient work in that field.

If interested, here's some papers to read over:

One about neuroimaging:

http://www.psych.nyu.edu/phelpslab/papers/06_BiolPsych_V60.pdf

Sleep distrubances in PTSD and some treatments:

http://www.mediafire.com/?tixmyze4duf

And an article in the Psychiatric Times:

http://www.psychiatrictimes.com/display/article/10168/1147506?pageNumber=1

A video of a round table lecture about PTSD and traumatic brain injury:

http://video.google.com/videoplay?docid=1908465038353454101&ei=aE9dSc3OF4OorwKv76n3Cw&q=PTSD+brain&dur=3

And this episode of the Secret Life of the Brain deals with PTSD amongst other topics:

http://www.youtube.com/watch?v=xh4Y0KvXOgU

http://www.youtube.com/watch?v=YRU8vklfckk&feature=related

[Kylyssa]

Nice links, oh Squidish one.

[Squid]

Nice links, oh Squidish one.

No problemo.

[Wraitchel]

Very cool. Thanks for coming through with your strong scientific mind.