How to conquer trauma?

Disclaimer: This blog is a bit long because it’s an attempt to synthesize from multiple sources, as well as from my own views. I am not an expert on this topic, so please treat it as a reference rather than something authoritative.

Introduction

My curiosity in trauma perhaps stems from my own experience, the fact that I seem to recover from them reasonably well (relatively compared to others, that is), and the observation that it doesn’t seem to be the case for many others. There are a lot of things that make our lives difficult, but I think the failure to recover from trauma is often, if not always, the most difficult thing to deal with. Unresolved trauma can manifest through unhealthy coping mechanisms, excessive rationalizations, unconscious pathological behaviors, and much more.

In this blog post, I examine the phenomenon of trauma from both biological and psychological levels to grapple with the question: how can we conquer trauma? The answer is pretty short and simple, but it is important to provide the arguments to back it up.

I draw ideas from many books: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma which talks extensively on trauma and its biological basis, and 12 Rules for Life: An Antidote to Chaos which talks about how to establish order in the face of chaos, and Strategic Intuition: The Creative Spark in Human Achievement which talks about the neuroscience of intuitions (among other things).

Interestingly, this blog post wasn’t planned, but the idea spontaneously emerged when I was linking my notes together from these books.

Traumatic experience, chaos, and order

When a housewife discovers that her husband cheated, not only her conception of her husband falls apart, but also her conception of herself falls apart. He wasn’t who she thought he was, she wasn’t who she thought she was, the world wasn’t what she thought it was. There’s a disintegration on the conceptual level.

But there’s also disintegration on the biological level. The amygdala - the brain region which controls fight or flight response, evolves to respond to snakes and things that pose a physical threat to us. However, the brain is very efficient at reusing existing circuits for new purposes, so not only the amygdala is triggered when you see a snake, but it’s also triggered by the category of experience of which the snake is a manifestation - things that lurk outside of what you can see which can kill you. A traumatic experience, which is a disturbing event that exceeds one’s ability to cope, roughly belongs to the same category. That category is also chaos because chaos is exactly what lies outside of the order you established which can disintegrate you. In other words, a traumatic experience is a manifestation of chaos.

Jordan Peterson said that to re-emerge from chaos, you need to separate the intolerable general conditions of being from the particular details of your specific catastrophe. It isn’t everything I thought I knew is wrong, but specific beliefs were wrong. It isn’t everything that fell apart, specific things did. What are they? How can they be fixed?

He was making a point that careful attention and articulation can help you establish order out of chaos, but only if you are willing to step out from the veil of ignorance, your inattention, and the fear of what lurks underneath that catastrophe.

It’s a remodeling of your conceptual structures. But when we talk about such terms, we are assuming that we can do it amidst traumatic episodes. Specifically, the idea presupposes that we retain our ability to reason when it comes to the traumatic experience, which is not always the case as will be explored briefly.

One common application of this idea is in psychotherapy where patients are encouraged to talk about trauma to gain mastery over them, which has been criticized due to its questionable effectiveness. But I think it makes sense when we consider what’s going on in the brain of traumatized patients.

Of course, it doesn’t mean that we should not strive to articulate trauma carefully and thoughtfully. It’s just that we must also be aware of the biological factors that drive such experience so that appropriate interventions can be prepared.

How does an unhealthy brain work?

The two-sided brain theory by Roger Sperry

The theory was put forth by Roger Sperry. It began during World War 2. The first research subject was an American soldier named W.J - a high-school graduate with above-average intelligence.

W.J survived a fall but received a blow to his head and then another blow during his capture. When he was released after the war ended, he started to suffer from episodes of epilepsy. After receiving a callosotomy (a procedure that severs two hemispheres), the seizures stopped. W.J, who had been having more than 10 seizures a day, was declared cured after 6 months.

Roger Sperry then gave W.J a series of tests that stimulate one side of the brain and see if the other side responds. Since W.J’s brain is split, different stimuli that work on one side but not the other tells us what each side is uniquely capable of.

W.J was blind-folded and given certain objects. He had to use and then name the objects. When using his right hand, he was able to both use and name them. When using his left hand, he was able to use but not name them. Since hemispheres connect to the opposite side of the body, it means that the right side handles complex tasks but not language, while the left side handles both.

A breakthrough came when an experiment was designed where three-dimensional forms held in the right and left hand respectively had to be matched with their unfolded shapes, which are visually presented to the subjects. It was found that the right hemisphere was much more superior than the left hemisphere in that particular task.

It was concluded that the right hemisphere is specialized for Gestalt perception, being primarily a synthesist in dealing with information input. The left hemisphere operates in a more logical, analytic fashion. Therefore it is not adequate for the rapid complex syntheses achieved by the right hemisphere. This gave birth to the whole right-brain left-brain trend that became popular.

Another domain where the right hemisphere is more specialized is emotions, which makes sense if you think of emotions as rapid complex syntheses. With sufficient rationality, you can unpack an emotion into many intertwined components, each tracing back to events years prior encoded into particular sensations.

However, it is worth noting that, this theory does not generalize well to healthy individuals, because it originated from experiments conducted on split-brain patients. Later inventions on MRI techniques demonstrated that, in a healthy brain, the left and right hemisphere simultaneously handles both logic and emotions.

If only one hemisphere is activated, then it marks the beginning of something pathological, which is precisely what happens in traumatized patients.

Problems with traumatized patients

Traumatized patients have only the right hemisphere activated

Looking at brain scans of traumatized patients, there is a significant decrease in the activity of the left hemisphere. The Broca’s area, which is in charge of speech production, goes offline when a flashback is triggered.

We know that the right brain is roughly intuitive, emotional and the left brain is roughly linguistic, sequential, and analytical. Normally, the two sides of the brain work together smoothly, but traumatized patients may have the left hemisphere dampened, and the right hemisphere activated whenever they are reliving the experience.

This impacts the ability to organize experience into logical sequences and translate our feelings into words. Without sequencing, we can’t identify cause and effects, grasp the long-term effects of our actions, or create plans for the future. This failure to make sense also contributes to the reenactment of traumatic events, because those who can’t learn from history are doomed to repeat it.

Traumatized patients seek reenactment because they are addicted to the trauma

Traumatized people tend to be excited and come to life when talking about traumatic events. Soldiers like to talk about their helicopter crashes and dying comrades. Raped victims may fall into prostitution over and over again despite having received help.

Freud calls such traumatic reenactments the compulsion to repeat. Research has shown that activities that cause fear or pain can later become thrilling experiences because they release morphine-like substances. We may get hooked up on activities like marathon running, sauna bathing which initially causes discomfort and terror but becomes enjoyable.

This gradual adjustment signals that a new chemical balance has been established within the body. We start to crave the activity or experience when it’s not available. This theory could explain why some people hire someone to beat them, or they are only attracted to people who hurt them.

The bottom line is, we are unable to articulate our thoughts and feelings when we relive traumatic experiences because the left hemisphere is shut down while the right hemisphere lightens up. When the right hemisphere lightens up, we experience intense vivid emotions and pain, which can cause morphine-like substances to be released in the brain. As a result, we seek more dangerous behaviors in order to reproduce these highs and become more addicted to the trauma.

Traumatized patients tend to tell a narrative of victimization rather than the reality of their experience

The left hemisphere is responsible for linguistic, which is deactivated during traumatic episodes. Therefore it is difficult for traumatized people to articulate their feelings.

When your left hemisphere is compromised, you lose that ability to dissect the particularities of your own experience. In more abstract terms, it takes away your ability to establish order. At that moment, what you experience is pure chaos, because there is no order and nothing makes sense.

In a world that seems to be falling apart, along with the perception that we are incapable of putting it together, it is easy to apply the generally intolerable conditions of being to construct a narrative that positions ourselves as the victim, and the world as the oppressor. This is how many people rationalize their ineffective operations in life: a helpless victim can do nothing but wither away at the hands of a malevolent oppressor.

How does a healthy brain work?

The reptilian brain, the mammalian brain, and the neocortex

The brain is built bottom-up. At the bottom is the reptilian brain. It is already online when we are born. It enables things babies are capable of: sleeping, eating, defecating, urinating, crying. It coordinates the heart, the lungs, and the immune systems, ensuring homeostasis in which these life-sustaining systems are maintained.

Right above the reptilian brain is the limbic system, also called the mammalian brain, because all animals that live in groups and nurture their young ones possess one. It regulates emotions, determining what’s pleasurable and what’s scary, essentially mapping how we interact emotionally with our surroundings. The limbic system is shaped partly by experience, partly by genetic markups. Children constantly experiment with the world, and these experiments help develop the limbic structures for emotions and memories.

The reptilian and the mammalian brain altogether is called the emotional brain. The emotional brain is responsible to detect danger or opportunity and responds by releasing hormones that interfere with whatever your mind is focused on. The emotional brain affects what we choose to eat, where we choose to sleep and with whom, what music we prefer, whom we befriend, and whom we detest. The emotional brain initiates preprogrammed automatic escape plans, like fight or flight responses.

Above the mammalian brain is the neocortex, which is responsible for manipulating abstract ideas. Notably, frontal lobes in the neocortex enable planning, reflection, integration, and interpretation of information. Generations of frontal lobes working together have provided us with inventions that literally changed the world. The neocortex is also referred to as the rational brain.

The emotional brain identifies danger like a smoke detector

Sensory information is passed to the thalamus, an area inside the limbic system that combines inputs from our perceptions into a fully blended autobiographical experience of “this is what is happening to me”. The sensations are passed on to the amygdala and the frontal lobes.

The amygdala is “the low road” which determines if a situation is dangerous or not. It does this with the help from the hippocampus which relates new input to past experience. The amygdala responds to a threat by sending an instant message to conjure up a fight or flight response. The frontal lobes, which is “the high road”, react milliseconds later, only after threats have been registered in the body.

The amygdala is like a smoke detector, determining if the input is relevant to survival or not. You can get along with people only if you can accurately gauge whether their intentions are benign or dangerous, therefore trauma which dampens the frontal lobes and elevates the amygdala results in overreaction and misinterpretations of situations that damage relationships and quality of life.

The rational brain controls the stress response like the watchtower

If the amygdala is the smoke detector of the brain, then the frontal lobes are like the watchtower - offering a comprehensive view of the situation instead of just the fight or flight responses. Is the smoke you smell the sign of the house is on fire or just the steak you put over too high a flame? The amygdala doesn’t make such judgments and just tells your body to get ready.

The executive functions of the prefrontal cortex enable people to observe what’s going on, predict what’ll happen if they take a certain action, and make a conscious choice. The presence of mind is the capacity to calmly observe thoughts, feelings, and emotions in order to inhibit, organize and modulate the hardwired reactions. As long as our frontal lobes are working, we’re unlikely to lose our temper every time a slightly unpleasant thing happens.

How to conquer trauma?

Dealing with stress depends on achieving a balance between the smoke detector and the watchtower

In PTSD patients, the critical balance between the amygdala and the frontal lobes shifts radically, which makes it harder to control emotions and impulses. Human beings in highly emotional states have elevated activity in the emotional brain and reduced activity in the frontal lobe.

Effectively dealing with stress depends upon achieving a balance between the smoke detector and the watchtower. You can learn to regulate emotions from the top down or from the bottom up.

Top-down emotional regulation involves strengthening the capacity to monitor your body’s sensations through mindfulness and yoga. Bottom-up emotional regulation involves recalibrating the automatic nervous system through breathing, movement, or touch. When you learn to calm down, either through the habit of mindfulness or through a touch of a friend, you essentially increase activity in your left hemisphere and decrease activity in your brain hemisphere. Only then can you begin to process the information contained in the traumatic experience in any meaningful way.

Establish order out of chaos when you have successfully calmed down

It’s very important to note that, just because you meditate or practice mindfulness, it doesn’t mean that you have gained mastery over your traumatic experience. Meditation and mindfulness only help prepare and empowers your rational brain and quiets the emotional brain.

Likewise, traumatic experiences are not overcome merely by hugs and intimate touches. They only help calm your emotional brain. Traumatic experiences are as much a psychological issue as they are biological, so we need to take the final step and re-establish order through attention and articulation.

To quote my own blog post which draws on Jordan Peterson’s idea:  when things fall apart, we can give structure to it, and re-establish order, through our speech. If we speak carefully and precisely, we can sort things out, and put them in their proper place, and set a new goal, and navigate to it. If we speak carelessly and imprecisely, things remain vague. The destination remains un-proclaimed. The fog of uncertainty does not lift, and there is no negotiating through the world.