EMDR - An understanding of trauma
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What is trauma?
Everyone has experienced trauma, but many people don’t have a good understanding of what that means. There’s an idea that trauma is only a trauma if it would be judged so by other people; in actuality, it’s the opposite: trauma is an internal perception of experience, and will look different for each person.
I’ve had numerous clients state that they haven’t had trauma, and then follow that statement with a denigration of their own experience, shaming themselves for their reactions or emotions. I'll hear people describe a series of painful incidents, and connect those incidents to equally painful after-effects, then dismiss it all by saying "but it wasn't a trauma," or something to that effect. In doing so, they undermine their own experiences, or if speaking with parents, they underestimate the potential trauma suffered by their children. This is most disturbing to me when it prevents people from accessing the care that could help them recover and move past their difficulties; when they say that EMDR isn’t the right therapy because it is for trauma, and that’s not their issue.
My hope in writing this post is that if people better understand what trauma is, and how it affects the brain, they can become more compassionate with their own experience of it.
A helpful concept in EMDR is the idea of Trauma v. trauma:
“T” Traumas are – wars, assaults, natural disasters, car accidents, devastating illness etc. that affect us dramatically, and shockingly. This is what most people think of as trauma. Something that knocks us out of our normal life, and is so big we can’t integrate it; we aren’t the same person afterward. These are events that would be easily identifiable as trauma by other people. These are also events that are likely to elicit empathy, support, and validation from others.
“t” traumas are – experiences that lower our sense of self-confidence and self-efficacy. These are often perceived as less important, but can actually be equally devastating. “Like a perceptual filter, they narrow and limit our views of ourselves and the world, and prevent us from living to our full potential” ~ Laurel Parnell. Examples of these might be a disparaging parent, developmental trauma, growing up with neglect, sexism, racism, bullying. These are traumas that are not as easily identified, or understood. In many ways, these are actually the more insidious traumas; they are more difficult to work with, in part because they aren’t so easily understood. There is a lot more internal and external resistance to validating our experiences of them. These traumas tend to evoke the idea of “pull yourself up by the bootstraps,”or “suck it up,””stop being a baby;” these tend to elicit a shame response.
Just a little neurophysiology as it relates to trauma:
Trauma is held emotionally, cognitively (in your thoughts), and somatically (in your body). To thoroughly process trauma, you have to address all three. This is why EMDR is so effective, by activating left and right hemispheres of your brain, EMDR is integrating information and perceptions that are otherwise held separately.
Trauma disrupts natural memory integration. Traumatic incidents are stored in our brains in separate, fragmented sensory (visual, auditory, olfactory), and cognitive memories; they are frozen, outside of time (thus the perfect recall of PTSD). Trauma is re-experienced largely in the emotional right side of the brain. Interestingly, Broca’s Area, where we process language, happens to be in the left. This is one of the reasons why talk therapy is not as effective as EMDR when processing trauma.
When triggered, people with PTSD are operating out of their right brain; they aren’t objectively analyzing and categorizing triggering information, their ability to talk can be limited because the left hemisphere is largely shut down. The trauma is held outside of time, as alive now as it was during the original incident. They have more active limbic systems.
Talk therapies and mindfulness can affect the limbic system, but they are limited, indirect, and very effortful. Meaning that when the person is tired, overwhelmed, not at full capacity, the ability and motivation to find and maintain mindfulness, or conscious control is diminished.
The corpus callosum is a thick, nerve rich, pathway between the left and right hemispheres of the brain. It is vital for coordination and communication between the two hemispheres, and it is not developed in children until the age of 4 or 5. Left/Right brain communication is very limited before that age.
When children experience trauma, the right side of the brain lights up, but because they don’t have a developed corpus callosum, advanced language skills, and life experiences, they can’t attach meaning and narrative to their trauma, they have no context with which to make sense of it. The memory is held in this unintigrated and unprocessed state, linked to all of the sensory triggers of the original event.
Synaptic pruning is a way of making our brains more efficient by eliminating unnecessary neural connections; it is the embodied concept of “use it or lose it.”
Early childhood trauma causes more synaptic pruning, and predisposes people to PTSD. The focus is on survival, so those are the neural connections that are prioritized. It effects physiological brain development, makes self-soothing more difficult, and creates a more active sympathetic nervous system.
The results are that people tend to feel pain more, and are more prone to depression. It basically creates a “shattered nervous system,” and walking the world can feel like you have no protective skin.
People who end up with PTSD are often the ones who also had childhood trauma. With these clients it is harder to work on single incident trauma because events link up emotionally to their early childhood.
In a nutshell:
Ordinarily, we rely on our brain to function as a whole, our prefrontal cortex does our fine reasoning, our hippocampus evaluates information and sees patterns, our cerebellum creates meaning and associations, our thalamus integrates everything (left/right, limbic system/cortex).
When we are experiencing a trauma, and are too overwhelmed by stressful stimulation, we tend to drop down to functioning from more basic areas of our brain, designed to keep us alive, our limbic system (emotional processing, long term memory), and especially our amygdala (fight, flight, faint, freeze). The amygdala doesn’t hold context, it reacts; immediately activating the sympathetic nervous system to respond to threat. During trauma, our thalamus, which provides context by bringing together information from all areas of the brain, shuts down.
Trauma processing: bilateral stimulation (BLS) causes the thalamus to come back on-line which means that those discretely held, fragmented sensory memories can integrate; context is allowed back in to affect perception.
There is hope!
Sometimes talking about the neurophysiology of trauma can feel depressing. It’s important to keep in mind that all of these processes work in the other direction, as well.
Processing the root experiences creates a generalization effect that carries up the memory network. With EMDR we start with what is present, we follow that emotional, or sensory connection as far back as we can, and focus on the root memory however it is stored. When that original memory is processed, every memory that you have that is neurologically linked to it, is also affected.
“Use it or lose it”can be a very powerful tool for shaping your brain, your emotions, and your life. The more time you spend in positive, nourishing experiences, including resourcing in therapy and self-care, the stronger and more accessible those neural networks will become.