Vajra Blue

Mindfulness and Compassion. Understanding trauma in young people.

Trauma Informed Care: Trauma and the Brain.




“The traumatic stress field has adopted the term “Complex Trauma” to describe the experience of multiple and/or chronic and prolonged, developmentally adverse traumatic events, most often of an interpersonal nature (e.g., sexual or physical abuse, war, community violence) and early-life onset. These exposures often occur within the child’s caregiving system and include physical, emotional, and educational neglect and child maltreatment beginning in early childhood.”

– Developmental Trauma Disorder”
― Bessel A. van der Kolk

People who have survived significant developmental trauma often show behaviours that seem to be counterproductive.  They act in ways that can make their situation worse, and the degree of behavioural response seems, at times, to be unrelated to the the size of any triggering stimulus.

This is a direct result of the impact that developmental trauma can have on the developing brain, people who have such Trauma Organised Brains, may behave in ways that appear to make little sense to a rational observer.  However, with the greater understanding that modern neuroscience is providing about brain functioning, such apparently irrational actions and damaging responses can be more clearly understood.

As we grow up in our family, in our street, in our town, we learn how a human being in our culture is expected to behave. One of the key skills is learning to modulate our emotional responses to events, and to engage our neocortex – the thinking and planning part of our brains – to help us to control the brain’s inner, automatic responses to the world around us.

This learning literally takes place at our mother’s knee. Or at least that of our primary care giver. From the moment we are born we begin the process of learning how to control our responses to the events and stimuli that arise from our environment, be it a wet nappy, hunger, a loud and unexpected noise, or a man with a machete.

Learning literally takes place at our mother’s knee.

This is where the concept of “good enough parenting” comes into play.  If our needs and upsets are dealt with in a timely way, we gradually learn to manage and control our responses to them.  We come to recognise that they do not last forever, and that they can be contained and revealed as nothing more than passing physical or emotional states. We slowly and steadily learn to control these internal states for ourselves as we grow towards adulthood..

This process depends on the relationships we develop with our nearest care givers.  If these relationships are supportive and timely, then we learn these skills well and we then develop a secure base from which to go out and explore our world. These close relationships with other humans help us to learn how the members of our culture handle relationships, how to deal with stress, and how we can learn to thrive as human beings.

When these relationships go awry, whether through accident, illness or deliberate action, we struggle to deal with these important aspects of the human condition.

Our brains develop differently, becoming trauma organised.

The accelerating pace of research into brain pathways, helps to cast light on the developmental changes that are seen in a traumatised brain, changes that are to some considerable extent “hard wired” into the person’s psyche.

Much of the learning that we do is aimed at being able to control our innate fight, flight, or freeze response. Humans have very well developed systems for dealing with danger, and it is clear just how effective they are, given the nearly eight billion souls that currently inhabit planet earth.

Even half a second could make the difference between life and death.

Survival mode involves preparing the body to fight or run. One of the most important things that happens when we enter this state is that the neocortex – the latest part of the brain to develop, and the part with which we think and plan – is effectively switched off.  Thinking takes time, and where our survival is concerned even half a second could make the difference between life and death.

When brain development has occurred along healthy lines the cortex continues to communicate with the limbic system (where our threat detection and emotional systems are to be found). This allows us to learn from experience as we compare what is currently happening with past events.  We can than select an appropriate response, and act after considering the consequences of our actions.

In the young, a threat – a wet nappy or some other danger – tends to trigger the limbic system first, meaning that the frontal lobes cannot respond to the perceived threat and evaluate it.  Hyper-arousal, as seen when we are in a danger situation, prevents activation of the frontal lobes and means that we fail to learn from the event, and this will also result in impaired problem solving.

The part of the limbic system involved in this response is called the Amygdala, a kind of human threat detector that allows us to respond rapidly when we appear to be in danger. Activation of our Amygdalas causes the rapid release of stress hormones into the body. These hormones are designed to assist in our fight, flight, or freeze response, preparing us for the extra exertion that a dangerous situation might require.

When the frontal lobes are inactive there is no feedback that can switch off the Amygdala’s responses, so it continues to sound the alarm unnecessarily and repeatedly. This is one of the mechanisms that underlies many of the symptoms seen in trauma victims.

Another part of the brain, the Hippocampus, helps to process information and create memories. The Hippocampus helps the brain to process information, especially new information, assisting in this transferring information from our senses to the cortex, helping to make sense of the incoming stimuli.  If these stimuli are assessed as threatening, then the process may not occur, as the usual learning pathway is short circuited by the need to survive.

The Hippocampus helps provide context to our memories and the events of which we are part. Location, time, and position in space, are just a few of the contexts that may be provided.  This process seems to depend on neurogenesis – the growth of new nerve cells – in the Hippocampus. It is in this process of neurogenesis that stress hormones interfere with normal processing. These chemicals adversely affect the Hippocampus, suppressing it’s activity so that it stops functioning effectively.

When this happens, we become unable to differentiate genuine threats from those that are imaginary, and may respond to minor threats as though they were of much greater significance. Our cortical processing is inhibited, and this can result in an all or nothing response to what might only have been very minor triggers.

The same processes that switches off our ability to think also inhibit our memory, resulting in what is called poor declarative memory – the ability to recall facts and explicit verbal knowledge. At the same time our procedural memory – the learnt behaviour memory that lets us remember how to ride a bicycle – remains unimpaired.  We can then make what are out dated behavioural responses to our current predicament, a process that contributes to the regressed behaviour that is often seen when we find ourselves under threat.

Underdevelopment of left hemisphere functions and relative overactivity of the right hemisphere.

Emotional memory is left relatively intact and this is another function of the Amygdala. Emotionally arousing material is encoded and stored in such a way as to be easily retrieved.  This ability to recall previous dangerous situations makes a vital contribution to human survival.

When such changes occur during early development they can have even more far reaching effects. Children with a history of abuse are twice as likely to have abnormal changes on their EEG as those without. These changes seem to reflect underdevelopment of left hemisphere functions and relative overactivity of the right hemisphere. This is accompanied by a reduction in the volume of the Corpus Callosum – the nerve cell connections that allow the two sides of the brain to work together.

The failure of the two sides of the brain to work in unison can lead to marked shifts in mood and personality. Such changes can be dramatic and switch very rapidly. Early abuse and neglect also impact on neuroendocrine systems sending brain/hormonal interactions out of kilter. In the young child this can bring about changes in the brain as it adapts to an abusive and threatening world. Brain pathways can become hard wired, and stress genes that are usually dormant, can become activated.  These activated genes can later be passed  on – in the active state – to our children. The epigenetic transmission can pass on increased risk of altered stress responses from one generation to the next.

Brain pathways and systems that help regulate many of our other behavioural and emotional systems can also become impaired.  This may lead to marked dysregulation of mood, with rapid changes from one state to another, resulting in an easily aroused fight and flight response, an exaggerated somatic stress response, impaired immune system function, and interference with normal digestion.

A state of constant hyperarousal in preparation for a threat that may never come.

These changes cause to difficulties with the regulation of many of our psychological and social responses and behaviours. This can lead to considerable impairment in functioning, and produce many of the long term sequelae of abuse, trauma, and neglect, such as depression, anxiety, self harm, poor social relationships and the use of drugs or alcohol to help control their distressing emotional responses. Depressed trauma survivors often show even greater elevations in cortisol and other stress hormones including those involved in the fight or flight response. The result is a state of constant hyperarousal as we get ready to respond to a threat that may never come.

Such states of hyper-arousal can persist throughout adult life, resulting in a continuing perception of threat even once the original  danger is long past and the current environment is safe. We can literally  respond to threats that have been non-existent for many years.

Less chance of exacerbating their traumatised state.

This altered memory function – where memories of danger have been retained, and are too easily accessible – contributes to the greatly increased reactions that are seen in response to minor stimuli, while other memories that might have helped to prevent this situation were not been laid down in the first place.

Next time you see a distressed person who has been the victim of developmental trauma, bear in mind that their brain may be working differently because of these developmental changes.  Changes that occurred secondary to the environment in which they developed.

If we can come to appreciate this we are then in a position to offer help.

Help that is more appropriate to their needs, and in a fashion that stands less chance of exacerbating their already traumatised state.

Author: SandySB

Child and adolescent psychiatrist. Parent. Blogger.

3 thoughts on “Trauma Informed Care: Trauma and the Brain.

  1. I experienced this as a child, the hyperarousal, the constant fear, the constant criticism.

    It is reversible, impermanent because of the plasticity of the mind.

    With daily mindfulness practice, integration, affirmations and application, I healed.

    I became friends with my amygdala and implicit memories were integrated

    Sort of like the amygdala was emptied of all the early childhood trauma.

    The secret is the amygdala and how mindfulness can reach it where conscious attempts can not impact implicit memory or the amygdala.

    Check out the ACE study and how early childhood abuse leads to cancer, addictions mental illness and death.

    Liked by 1 person

    • It is the research you mention and others that suggests that the risks here are ones that go beyond “just” the direct effects of the trauma.