How does your brain deal with a difficult trauma?

We know there are mechanisms in our brains and bodies for processing – getting rid of – trauma because many people often fully or significantly recover from all types of trauma. Sometimes these mechanisms are explained in concrete, scientific terms e.g. the interplay between different parts of the brain, and sometimes they appear to defy explanation when trauma disappears, as if by magic. What’s not in doubt though is the fact that mechanisms do exist. This article looks at examples from my own therapeutic practice to better understand the way our brains deal with trauma.

Why does trauma affect the brain after the event?

When someone no longer suffers from trauma, it means that key mental and physical systems affected, such as the brain’s limbic system (involved in emotion and memory) and nervous system, have been ‘persuaded’ that their owner is no longer at risk. I use the term persuaded deliberately. While human beings have some influence over their mental and physical systems, these systems also act independently. Anyone who has been traumatised knows all too well that their mental and physical systems have a life of their own. If humans were able to consciously resolve their trauma, this would be happening all the time and for all forms of trauma.

So, what persuades the systems involved that there is no longer any risk? Being able to answer this question is the task of effective trauma therapy. One reason is when key systems receiving sensory information – sight, sound, smell, touch, taste – no longer perceive that information as threatening. Another is when someone no longer believes they are at risk due to changes in their circumstances or identity. A third reason is when someone reframes – changes the meaning of – their trauma. All of these reasons, often in combination, can provide our key systems with evidence that their owner is now safe.

The examples I provide below are where clients have resolved their traumas quickly. Clearly this doesn’t always happen, but when someone’s life has a number of positive elements, e.g. no prior history of trauma, supportive relationships, sources of meaning and purpose such as work, it is often possible. I have learned there is no right or wrong way; it is often a process of trial and error to find out what works. All details have been changed to protect the identity of my clients.

Peter’s story – post-combat trauma and the role of belief

Peter came to see me having experienced a series of traumas, initially, while he was in the armed forces and then in his role as a fireman. The first trauma involved the loss of a friend in battle. The second trauma was a distressing suicide attempt, and the third involved being trapped in a house that was on fire. Previous trauma treatment of EMDR (Eye Movement and Desensitisation Reprocessing) and CBT (Cognitive Behavioural Therapy) had exacerbated Peter’s trauma because, in his own words, asked ‘me to think about what had happened and I didn’t want that.’ Peter asked me to focus first on the trauma of losing his friend in Iraq. What quickly emerged in our therapy was Peter’s low self-esteem and it was this that proved pivotal. Peter believed it should have been him that died in combat, not his friend, ‘…because he had more to live for then me.’ I had a hunch that changing this belief would be the key. I felt Peter had not responded well to more formal trauma treatment because it required him to be ok with getting better, and he wasn’t improving due to what he called ‘survivor’s guilt’. Peter and I came up with some alternative perspectives for his survivor’s guilt, i.e. why it was ok for him to be alive. We also looked at the positive things he enjoyed – he loves rambling around the UK and Europe – and together we wondered why, if he didn’t deserve to live, he deserved to enjoy his rambling. By our next session two weeks later, the change in Peter was obvious. He confirmed that he had experienced no traumatic symptoms for several days. He then told me about an incident he had attended that required him to rescue a young girl from a fire. Peter recalled how grateful the parents were to him – ‘If I hadn’t been alive, then they may have lost their daughter.’ Peter was able to acknowledge that he deserved not only to live, but to prosper as well. Three months later, Peter confirmed that he was ‘back to my old self’ and was still free of his traumas.

Jane’s story – self-harm: talking it through and seeing it differently

22-year-old Jane came to see me because she was tired of being anxious and depressed. Her mental health had been poor since she was a young girl, and she was putting herself at constant risk in the form of self-harm and suicide. After three sessions, Jane reported some improvement in her mental health, but not much. In our fourth session, she spontaneously told me about an incident when she was 14 years old on a school adventure holiday. Jane told me that someone she had become friends with, an older teenager, whom she knew to be 19 years of age, had sexually assaulted her. The assault had not been ‘serious’ as Jane described it – ‘He tried to kiss and grope me’ – and she had managed to run away. As she ran away, Jane said he shouted it was her fault. ‘I believed him,’ she said. The trauma had stayed with her ever since and had impacted hugely on her self-esteem and relationships. Jane could not easily trust people and had never had a boyfriend, which she desperately wanted ‘because all my friends have one.’ I let Jane tell me about the event uninterrupted. When she had finished, I asked her if she had told anyone else before. ‘No,’ she replied, ‘never.’ I told her it was never anyone’s fault to be assaulted. Jane told me this ‘was massive,’ and soon after she ended her sessions with me, reporting that she was ‘feeling happy.’

Tom’s story – policework: changing the meaning of trauma

Tom, a police officer, came to see me as he was suffering from the effects of a serious assault three years earlier. There were no areas of his life unaffected by his experiences. His GP had diagnosed him with anxiety and depression and signed him off sick from work. Due to the severity of his mental health, in the first three sessions, very little therapeutic work could be done other than making him feel as safe as possible. In his fourth session, Tom was actively psychotic, reporting both visual and auditory hallucinations. Spontaneously he said it was like he ‘was drowning in a deep, dark, black sea.’ I knew that this metaphorical representation of his trauma was potentially something I could work with. Parts of our brain – probably located in the right hemisphere – are known to record experiences in metaphorical form. These metaphors are commonly made up of different sensory elements such as imagery, colour, weight and temperature, which when altered can change how the brain remembers trauma. I asked Tom to describe his negative metaphor in sensory ways and then, through a series of stages, got him to transform this into a positive metaphor. In the first stage, I asked him to change the negative colour to one with positive associations, followed by weight and temperature. Then I asked Tom to change the imagery. Tom’s final representation was of him floating in a forest glade surrounded by purple flowers. He was bathed in warm summer sunshine with the noises of insects buzzing peacefully around him. At the end of session, we were both laughing uncontrollably, such was the transformation in Tom. We met the following week with follow-up e-mails at 6 and 12 months. Tom reported he was fine on each occasion. At no point did I know anything about the details of his trauma.

I hope these examples demonstrate what is possible when someone works with a therapist they both trust and who has the right knowledge, skills and abilities.

If you are affected by trauma and would like further information and support, then please get in touch. We offer a range of therapy and counselling sessions to help you come to terms with difficult events and experiences.