Thursday, August 04, 2016

Traumatic Memory ~ Talking Doesn't Always Help

In The Neuroscience of Traumatic Memory, Bessel van der Kolk and Ruth Buczynski explore how trauma affects the brain and how traumatic memory differs from other memories.

They note that some of the best therapy to address trauma is non-verbal.

Traumatic memory is formed and stored very differently than everyday memory.

Dr. Van der Kolk: If a person was abused as a child, the brain can become wired to believe, “I’m a person to whom terrible things happen, and I better be on the alert for who’s going to hurt me now.” 

Those are conscious thoughts that become stored in a very elementary part of the brain.

When trauma occurs: The brain becomes overwhelmed. That’s because the thalamus shuts down and the entire picture of what happened can’t be stored in their brain. “Instead of forming specific memories of the full event, people who have been traumatized remember images, sights, sounds, and physical sensations without much context.”

So instead of forming specific memories of the full event, people who have been traumatized remember images, sights, sounds, and physical sensations without much context. And certain sensations just become triggers of the past.

Dr. Van der Kolk: You see, the brain continually forms maps of the world – maps of what is safe and what is dangerous. That’s how the brain becomes wired. People carry an internal map of who they are in relationship to the world.

Implicit memory system: Rather than being stored verbally, traumatic memory is a much more elementary, organic level of a single sensation triggering the state of fear.


Dr. Van der Kolk: It’s important to recognize that PTSD is not about the past. It’s about a body that continues to behave and organize itself as if the experience is happening right now.

That’s why the main focus of therapy needs to be helping people shift their internal experience or, in other words, how the trauma is lodged inside them.

Talking can be less effective than nonverbal therapy: Talking can actually distract a patient from feeling, and from taking stock of what's going on inside.

Dr. Van der Kolk: All too often, when people feel traumatized, their bodies can feel like they’re under threat even if it’s a beautiful day and they’re in no particular danger. So our task becomes helping people to feel those feelings of threat, and to just notice how the feelings go away as time goes on.

This won't be forever: It’s important to help a patient learn that, when a sensation comes up, it’s okay to have it because something else will come next. This is one way we can help patients re-establish this sense of time which gets destroyed by the trauma.

Dr. Van der Kolk:  Once a patient knows that something will come to an end, their whole attitude changes. Sensations and emotions become intolerable for clients because they think, “This will never come to an end.” But once a patient knows that something will come to an end, their whole attitude changes.  

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