In Articles, Focus on Emotions

by Dr. Sarah Thompson, Clinical Psychologist

“Trauma-informed educators recognize students’ actions are a direct result of their life experiences. When their students act out or disengage, they don’t ask them, ‘What is wrong with you?’ but rather, ‘What happened to you?’”

Huang et al., 2014

As post secondary education becomes more accessible, we have an opportunity to work with individuals from more diverse backgrounds, including those with more diverse lived experiences. If we don’t understand how individuals respond to trauma, we run the risk of making negative assumptions about differences in behaviour, motivation, emotion regulation, and communication patterns that are a natural part of responding to past traumas. We run the risk of discounting people as unfit, or lacking the basic skills when really, they have lacked the appropriate environments (remember our orchids who flourish in hothouses, and shrivel in problematic conditions?). Worse still, we run the risk of further propagating systemic barriers to education for groups who have experienced increased rates of trauma by virtue of their experience of systemic oppression and the ‘large T’ and ‘small t’ trauma that inevitably entails.  

In the last article, we explored prevalence, definitions, and causes of trauma. In this article, we will focus our attention on a high level review of what happens to our minds and bodies during and following a traumatic event. Our capacity to hold in mind, and to help our students to hold in mind, what may be happening in their bodies at various times will help us to better understand, work with, and mentor students on a daily basis.

Hand Model of the Brain

If you’re completely new to neuroscience, or if it has been a while, start with this two minute video outlining Dan Siegel’s ‘hand model’ of the brain. It’s easy to remember and great for explaining the basic neuroscience of emotion to individuals of any age.  

Brain researchers such as Dr. Ruth Lanius, MD, Ph.D., have highlighted how important it is to understand trauma in terms of the three basic levels of brain function: 1) the brainstem or “reptilian” brain (the wrist in Siegel’s model) that governs basic bodily functions including maintaining homeostasis (e.g. regulating temperature, heart rate, blood pressure, physiological arousal levels, etc.), 2) the “limbic” brain (the thumb, tucked inside the fist, in Siegal’s model) which surrounds the  brainstem and is involved with memory, emotion, learning, and with some social behaviour, and 3) the neocortex (the fingers, curled around the thumb) which is responsible for, among other things, self-awareness, conscious thought, and planning and organizing. These brain regions are each highly specialized, and are highly interconnected allowing cohesive functioning as a whole. What you need to know about trauma is that it rewires the brain (to be fair, all learning does). Experiencing a traumatic event impacts multiple areas and aspects of our brain and nervous systems. We’ll focus on a few highlights below.

Trauma and the Body:  Turning “Hulk,” running the hamster wheel, and spacing out

At a very primitive level, we are hard-wired to respond to danger through reactions commonly known as fight, flight, and freeze responses. Some of these behaviours are mediated by the ‘reptilian brain’ or brain stem and are completely involuntary – we have no conscious control over them and experience these as reactions that happen to us, rather than actions we control. We share these response patterns with other animals – like the rabbit that startles and flees at a sudden movement, the deer who literally freezes in the headlights, or the dog that snarls and lunges at a sudden threat. According to Dr. Stephen Porges, PhD, developer of Polyvagal Theory, our bodies are hard wired with these very old evolutionary responses that have fostered our survival as a species. In his hand model of the brain, Dr. Siegel refers to moments when our neocortex and limbic systems become disconnected, when we ‘flip our lids’ – when our ‘thinking brain’ gets functionally disconnected from the rest of our neural system resulting in big emotional reactions or moments of freezing, spacing out, or disconnecting.

While these basic evolutionary response patterns of freeze/fight/flight make sense when under direct threat, in trauma these response patterns can become stuck in a variety of ways. When that happens, we see survivors of trauma continue to fight, flee, or to freeze when they encounter reminders of a past trauma. Lanius, Lanius, Fisher, & Ogden (2006) refer to this as a horizontal disconnection in the brain, when trauma forces a disconnect between our emotion and arousal management centres and our higher order thinking systems in the brain. For example, Babette Rothschild, in her book ‘The Body Remembers,’ gives the example of a woman who is assaulted by a man in a red sweater, understandably experiences intense fear in the moment, and later experiences intense fear again when she sees the colour red. Individuals who experienced rage or panic (fight or flight) when in present danger, may continue to experience signs of hyperarousal after a trauma – reactions that made perfect sense in a life-threatening situation, but that appear too big or as overreactions when they occur later in response to a reminder of the traumatic event (e.g. for example, hyperventilating when seeing a red billboard on the way to work the morning after an assault).  These reactions have been dubbed amygdala hijacks by Daniel Goleman. Other survivors experience a freeze response during a traumatic incident and may go on to develop post-traumatic stress responses that are a form of hypoarousal – reactions of numbing, slowing down, spacing out or dissociating when they face reminders of a traumatic event (e.g suddenly holding one’s breath, losing one’s words, and momentarily forgetting where one is after hearing words or sounds similar to those made during an assault).

If you notice one of your students suddenly disappearing, or “going from 0-100” in front of you, try using some of the emotion-coaching strategies we learned in an earlier article – sharing your observation of the student’s reaction and giving it a name. This may help the student come back into the present moment. Helping a student engage in a moment of self-reflection, naming their experience, and reorienting to their current surroundings can help to bring the neocortex back online if someone has “flipped their lid.” Calmly and compassionately validating someone’s response (“I see that something has upset/distracted you right now”) can also assist with regulating emotions, followed by expressing an interest in understanding the student’s response and offering to help in the moment.

Trauma and Memory – Missing the date stamp

Part of the reason we over- or under-react in the present moment when we are reminded of a past trauma has to do with how our brains encode memories. Memory encoding and retrieval are multifaceted and complex processes. For the purposes of this article, it is important to know that the brain encodes memories differently in traumatic versus non-traumatic situations. When we remember a non-traumatic event, we typically remember it as though we are telling a story about it after the fact. When we remember a traumatic event, we may feel as though we are reliving the moment – this kind of memory is sometimes referred to as a flashback. While non-traumatic memories often come out as a story with a beginning, middle, and end (sometimes including embellishments added to liven up the story!), flashbacks are often fragments of information taking in by our senses during a traumatic event –  a sudden intrusive image, a sound, a sensation in our body, a smell – typically accompanied by intense and disorganizing emotions like terror, rage, panic, or freezing in the moment.

The creation of flashback memories is mediated, in part, by stress hormones that are activated during heightened stress. During a single traumatic event, stress hormones, including cortisol and adrenaline, are produced in greater quantities in our bodies. Too much cortisol slows down processes inside various parts of the brain, including a part of the brain called the hippocampus (in the neocortex, or the fingers of the hand model). The hippocampus helps us encode new memories, including the context in which the initial event is occurring (E.g. Once upon a time, long long ago, I learned integral calculus sitting inside a large lecture hall in Sidney Smith building on the UofT campus. I then stopped using integral calculus and lost that capacity!). When the hippocampus is slowed down, we may not encode important information about the details of an event.

During a period of high stress, adrenaline increases functioning in the amygdala, a part of the limbic system (or thumb in Siegel’s hand model) that helps mediate our emotions and emotional responses. When the hippocampus is slowed down and the amygdala is sped up, we encode memories in a fragmented way. In the days following a traumatic event, individuals are more likely to remember snippets of memory, often out of order like viewing small pieces of a film reel that have been cut out and strewn on the (old fashioned) editing room floor (E.g. in the days following a car accident, I may suddenly recall the sound of a horn blaring, later believe I am smelling burning rubber, and at another time startle as I believe I am suddenly seeing something moving out of the corner of my eye).

There are many complicated changes when cortisol and adrenaline (also known as epinephrine) are high but for the purpose of this article, and when speaking to my own clients, I like the metaphor of ‘time stamping’. You know, when you submit that assignment at 11:59pm, one minute before the midnight deadline, and you rely on the computer’s time stamp to advise your professor or supervisor that indeed, the assignment was submitted on time, and which tells your body that your work on the assignment is done, over, finito. You can now stand down, relax and enjoy a moment’s pleasure before moving on to the next task.  

Now imagine that that assignment is instead a traumatic event. When a traumatic event is occuring, it’s important to also know when it ends. The problem? It’s like the hippocampus (and associated connections to the ‘rational’ prefrontal cortex) hold memory’s date stamp – in part by organizing memories into understandable and meaningful narratives with a beginning, middle, and end. When the hippocampus is slowed down and a memory is stored via the amygdala, these trauma-related memories are more likely to be stored as disorganized sensory fragments. These fragments may be flashes of a sight (like ‘mini movies’ or snapshots in the mind), isolated sounds, smells, or sensations in the body. Memories like this often aren’t understood as part of a meaningful whole experience. As such, it’s like they are remembered out of context and often, without a date stamp for your brain. Without a date stamp, your body does not understand that this internal experience, this memory fragment, is from the past. Each time one of these memories is triggered by something in your daily life, your body begins to react as though the event is still happening! You see/hear/smell/taste/feel something in your current environment that triggers an old memory of a traumatic experience. The parts of your brain that hold that memory begin to fire. These cells are linked to other cells which also begin to fire. When the amygdala is centrally involved and the hippocampus isn’t, it’s the rough equivalent of emergency alarms going off in your brain and getting your body ready for fight, flight or freeze right now – it’s like your amygdala can’t tell the difference between an incoming piece of sensory data (E.g. the sound of tree branches snapping under heavy ice after a storm) and memories of similar sensory data (the sound of gunfire during active military service in the past).  In both cases, your amygdala responds as though you are in danger now.

Let’s take a moment to consider the example of an ice storm.  An individual without trauma might experience the sound of snapping trees in this way: “Wow the trees are going to be heavily damaged by this storm and that makes me sad.” Someone with past resolved trauma experiences , but without active trauma symptoms might experience something like this: “Wow that sounds a lot like the gunfire I heard on active duty. That was the most stressful experience of my life. I think I’ll do something to take my mind off these memories.” For someone with active symptoms of PTSD or Complex PTSD, the experience is more likely to be something like this: Sound of snapping tree branch -> adrenaline surge -> startle response, sweating, shaking, shallow breathing -> flashbacks of combat -> fight/flight/freeze response (attack in rage, run out of the room, ‘duck and cover’) -> slowly realizing where they are and who they are with in the present moment – all happening over the course of seconds or minutes.

When we see a student behaving ‘erratically,’ suddenly going ‘from 0-100’ in feelings of anger or fear, we want to ask ourselves whether this student may be having a flashback or an amygdala hijack. If so, try speaking slowly and calmly to the student, maintaining non-threatening body language and posture, naming the reaction you are observing, empathizing with the student’s experience, stating your interest in understanding their experience and working with them to understand what is happening to resolve the concern. 

Trauma and Emotions

‘Flipping Your Lid’

When emotions run high, as Dr. Dan Siegel puts it, we can ‘flip our lids,’ literally experiencing reduced activity in our prefrontal cortex (part of that ‘new’ neocortex responsible for logical thought). At the same time, our limbic system becomes very active – the result – we sometimes run on autopilot, acting out big feelings rather than being able to think them through. To get our neocortex back on line, we need to soothe our nervous system by slowing our breathing, reflecting on what is happening in the moment, and finding our words.

‘There are no words’

Dr. Ruth Lanius has demonstrated that, when exposed to memory cues for a traumatic event, individuals diagnosed with PTSD are more likely to experience activation in their right hemisphere in areas responsible for retrieving nonverbal memories – that is, those experiencing post traumatic stress syndrome are less likely to have words and a story through which to express traumatic memories. Rather, they are more likely to experience the memory nonverbally.  Individuals who have not been diagnosed with PTSD are more likely to experience increased activation in the left hemisphere in areas associated with verbal memory retrieval. Helping a student narrate their experience, as they are able, may help to bring their left hemisphere and higher cognitive functions back online in the moment.

Coping with the biggest feels

“What we witnessed here was a tragic adaptation: In an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive.” Van der Kolk

Typically, when people feel unable to cope with sensations, emotions, and feelings associated with a traumatic event, and in particular when they don’t have the information and support they need to heal (to process trauma-related feelings and memories, to connect to others deeply, to feel safe in the world), they learn to numb emotions or to mask their primary pain in order to survive psychologically. People numb and mask emotions in many ways:

  • Through automatic and conscious behaviours: holding one’s breath or tensing certain muscles, avoiding certain people, places, and experiences that may remind them of the trauma, through overeating, through alcohol and drug use, through self-harm, and through suicide-related thoughts or actions as ways to try to get away from unendurable pain.
  • Through thought patterns such as: self-blame and a heightened sense of personal responsibility to offer a much needed sense of control (E.g. If only I could have been and can be different, that will never happen again; God chose to punish me so if I am a better person, I will be safe in the future); through blaming others for uncontrollable events; through convincing themselves that watching for danger every moment of every day will help them stay safe in the future.
  • Through primary and secondary feelings: feeling anxious or depressed instead of terrified, powerless, or alone; feeling ashamed of one’s terror or freeze response; feeling angry instead of vulnerable; feeling afraid and avoidant of powerful deeper feelings in general.

Trauma and Coping

How people have learned to cope with intolerable feelings in the past will have a big impact upon their rate of healing following a trauma. In past articles, we talked about managing feelings, and about attachment

Inner Critic: I feel anxious and jittery this morning, it’s just uncomfortable.
Response: Do you  know what you’re anxious about?
Inner Critic: No, it’s just this diffuse sense. Maybe it’s because I just gave my son more freedom to do something on his own than I have in the past? I’m not really sure about that though.
Response: What do you need?
Inner Critic: I don’t know. It’s not like there are any clear thoughts, memories, or images that are bothering me.
Response: OK, let’s try a mindfulness meditation to see if that soothes our nervous system.
Inner Critic: OK
Response: How are you feeling now?  
Inner Critic: Calm. Thanks.
Response: OK then, let’s get writing!
Inner Critic: Sounds good. Thanks!

If someone learned growing up that people can be trusted, and that when they ask for support they receive it, that person is more likely to ask for help as an adult. If someone has learned through their childhood experiences that others tend to be unpredictable, scary, or are simply ineffective and uncaring, they are more likely to try to cope alone – this typically exacerbates traumatic symptoms and impedes recovery.

If someone learned as a child to name their emotions, to accept and use their emotional responses as information, and learned how to regulate and manage big feelings, they are more likely to be able to tolerate and manage attending to their own internal experience in the aftermath of a traumatic event. Some researchers believe this is protective and may reduce the likelihood of developing PTSD symptoms following a traumatic event.

A note on trauma in childhood

When traumatic or adverse events happen in childhood, there can be greater consequences for our developing brains. Dr. Allan Schore, clinical psychologist, has written about the impact of early adverse experiences on the development of self-soothing capacities. He has highlighted the particular importance of experiences in the first two years of life when brain development is primarily focused on the right hemisphere. Individuals whose primary care-takers were unable or unavailable to provide safety and soothing in childhood may have an increased stress response and reduced self-soothing capacities in adulthood. These individuals may then have more difficulty regulating high stress levels throughout their lives and may need assistance to develop these capacities, especially after experiencing an overwhelming event.

There are many resources available related to trauma and healing. A variety are listed below for interested readers. While I do not endorse one route to treatment and healing over another, it is important to listen to your own body and to seek a treatment with an evidence-base behind it when seeking to heal from pervasive symptoms of trauma.

Putting it all together in a post-secondary context

What all of this means is that, when we see students (or colleagues) ‘acting out,’ it is helpful to maintain a curious and compassionate stance, knowing that something has likely happened to this person in the past that has primed them for the response they are demonstrating in front of you. This does not excuse dangerous or disrespectful behaviour – appropriate behavioural norms are important to maintain civil society and interactions. However, understanding what underlies a given response may assist us in maintaining compassion for others, and may assist us in understanding what is needed to address the current situation and to prevent a similar situation from recurring in the future.

Selected Resources:

For support following sexual trauma:

https://www.ryerson.ca/sexual-violence/resources/

Helping kids cope with trauma:  

https://www.canada.ca/en/public-health/services/reports-publications/responding-stressful-events/helping-children-cope.html

http://www.state.nj.us/njoem/pdf/chlcope.pdf

Adults and trauma:

 https://www.helpguide.org/articles/ptsd-trauma/coping-with-emotional-and-psychological-trauma.htm

https://thiswayup.org.au/how-do-you-feel/traumatised/

Mental health resources:

https://mindyourmind.ca/  (Age 14-29)

http://www.mentalhealthhelpline.ca/

http://www.mentalhealthfirstaid.ca/en

 

References:

Davidson, S. Trauma-Informed Practices for Postsecondary Education: A Guide. Retrieved from Oregon Community College website on April 25, 2017: http://occa17.com/data/documents/Trauma-Informed-Practices_FINAL.pdf

Hoch, A ., Stewart, D., Webb, K., & Wyandt-Hiebert, M . A . (2015, May). Trauma-informed care on a college campus. Presentation at the annual meeting of the American College Health Association, Orlando, FL.

Huang, L . N ., Flatow, R ., Biggs, T., Afayee, S ., Smith, K., Clark, T., & Blake, M. (2014) .  SAMHSA’s concept of trauma and guidance for a trauma-informed approach (SMA No. 14-4884) . Retrieved from U.S . Department of Health and Human Services, Substance Abuse and Mental Health Services Administration website: http://store.samhsa .gov/shin/content/SMA14-4884/SMA14-4884 .pdf

Lanius, R., Lanius, U., Fisher, J., & Ogden, P. (2006).  Psychological Trauma and the Brain: Toward a Neurobiological Treatment Model. In Ogden, P., Minton, K., & Pain, C., Trauma and the Body:  A Sensorimotor Approach to Psychotherapy. W. W. Norton and Company, Inc.: New York, New York.

Paivio, S., & Pascual-Leone, A. (2010). Emotion-Focused Therapy for Complex Trauma: An Integrative Approach. American Psychological Association: Washington, DC.

Rothschild, B. (2000). The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. W. W. Norton and Company: New York, New York.

 

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