Veneta Callpani, BS, MA, RDMS
When we talk about trauma, the neurobiology foundation is important to understand what happens to our brain and body when we are traumatized. With the advanced technology, scanning the brain with PET or fMRI helps scientists to track in real time the activity of the brain. Bessel Van der Kolk describes a couple experiments of how the brain responded during the re-introduction of the trauma memory months or even years after the traumatic event took place (van der Kolk, 2015). There were 3 regions of the brain that changed activity during the re-experience of trauma: limbic system, visual cortex, and Broca’s area. The surprising part of the scan was that Broca’s area went offline whenever flashbacks were triggered (van der Kolk, 2015). This explains why individuals have a difficult time describing what happened to them. Also, the difference between the right and left-brain sheds light on the idea that trauma shuts down part of the left brain (the rational part), therefore it is hard to make sense of time or understand that they are re-experiencing their trauma (van der Kolk, 2015).
One assumption of the socioecological model of trauma is that the majority of people won’t access clinical care after being traumatized. This can be explained by the lack of awareness individuals have about their traumatic experience. Even if at some point they do recognize their trauma, it is very hard for them to express it in words. This should be taken into consideration when thinking about the treatment or therapeutic approach. This is why I think EMDR can be a very good approach when targeting memories, and trauma that is “stuck” and unprocessed in the brain. Other alternatives can be somatic therapy, bodywork, or even acupuncture in cases when an individual’s response to trauma is numbness. Clients often share in therapy: “I wish I can cry. For some reason I just can’t. I feel numb”.
Neuroplasticity is one of the great features of our brain. It’s how we learn, how we create memories. But this very great feature that is necessary for our survival, our life and experience, can also work against us when it comes to trauma. As van der Kolk says, the repetition of the circuit firing can become a default, and if the repetition is trauma, then we get stuck and we keep experiencing the traumatic event/memory as if it’s happening now. The good news is that this allows our brain to “unlearn” the maladaptive coping mechanism by rewiring itself. Therefore, I would argue that when it comes to trauma, the experience is more important than the insights. So, the therapeutic relationship, and the experience of the therapy is more important than the talk and the insights that the client can get. I personally think that as a therapist, we should first focus on creating a positive experience, and a trusting therapeutic relationship before starting to work with trauma. This positive experience can be used as an anchor for the client to bring them back to the present and make them feel safe, once we start diving into the trauma work.
Something to keep in mind is that the therapist can also be a trigger of the client’s trauma and there might be manifestation of problems with trust (i.e., sexual abuse survivors), and the premature disclosure of trauma can induce re-traumatization, and leave the client feeling overexposed.
Van der Kolk, B. (2015). The body keeps the score: Mind, brain and body in the transformation of trauma. Penguin Books.