Trauma and the Developing Brain - College of Education & Human ...

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Handout for Trauma, The Developing Brain, Healing and Emotional Regulation Seminars Karina A. Forrest-‐Perkins MHR LADC, 2011 These changes in the central nervous system cause hypervigilance; under threat, the child tunes out all non-‐critical information. These actions prepare the child to do battle with or run away from the potential threat. This total body mobilization -‐-‐ the fight-‐or-‐flight response -‐-‐ has been well characterized and described in great detail for adults. These responses are highly adaptive and involve many coordinated and integrated neurophysiological responses across multiple brain areas, including the brainstem nuclei responsible for autonomic nervous system regulation. What Does Hyperarousal Really Mean? Hyperarousal is a multi-‐dimensional process characterized by both mental and physical changes. These include an increase in the activity of those parts of the central and peripheral nervous system responsible for the perception and processing of potentially threatening information . This graded response also involves action. During the hyperarousal process, many physiological systems required for survival are activated (e.g., stress response hormones such as cortisol and adrenaline). The many physiological changes during hyperarousal will influence the way a person thinks, feels, and acts. The Psychology and Physiology of Trauma The fight-‐or-‐flight response is a well-‐characterized reaction to danger, as we've already discussed. A second common reaction pattern to threat is dissociation. Dissociation is the mental mechanism by which one withdraws attention from the outside world and focuses on the inner world. It is increasingly clear that responses to threat can vary tremendously from individual to individual. This second major adaptation response to threat involves an entirely different set of physiological and mental changes, yet does not fall under the heading of either fight or flight. Many common and "normal" mental and emotional states such as anxiety, dissociation, or anger are experienced by most of us to some degree. When any one of these becomes pervasive and ever-‐present, however, it begins to interfere with the rest of one's life. This can happen with dissociation and anxiety. When it does wBecause of their small size and limited physical capabilities, young children do not usually have the fight-‐or-‐flight option in a threatening situation. When fighting or physically fleeing is not possible, the child may use avoidant and psychological fleeing mechanisms that are categorized as dissociative. Dissociation due to threat and/or trauma may involve a distorted sense of time or a detached feeling that you are observing something happen to you as if it is unreal -‐-‐ the sense that you may be watching a movie of your life. In extreme cases, children may withdraw into an elaborate fantasy world where they may assume special powers or strengths. 20
Handout for Trauma, The Developing Brain, Healing and Emotional Regulation Seminars Karina A. Forrest-‐Perkins MHR LADC, 2011 Like the alarm response, this "defeat" or dissociative response is graded along a continuum. The intensity of the dissociation varies with the intensity and duration of the traumatic event. (Remember that even when we are not threatened, we use dissociative mental mechanisms, such as daydreaming, all of the time.) During a traumatic event, all children and most adults use some degree of dissociation. However, some individuals will use, or experience trauma that induces dissociation as a primary adaptive response. For most children and adults the adaptive response to an acute trauma involves a mixture of hyperarousal and dissociation. During the actual trauma, the child feels threatened and the arousal systems will activate. With increased threat, the child moves along the arousal continuum. At some point along this continuum, the dissociative response is activated and a host of protective mental (decreased perception of anxiety and pain) and physiological responses (decreased heart rate) occur (see Figure 3-‐4 below). The Psychology and Physiology of Trauma The following points are an overview of human response to threat and trauma. Don't worry if you don't grasp all the concepts at first reading. We will be discussing these issues in greater detail as we move through our course. Consider this a preview of sorts. • The brain mediates threat with a set of predictable neurobiological, neuroendocrine, and neuropsychological responses. • These responses may include different survival strategies -‐-‐ ranging from fighting or fleeing to giving up or surrendering. • There are multiple sets of neurobiological and mental responses to stress. These vary with the nature, intensity, and frequency of the event. Different children may have unique and individualized sets of responses to the same trauma. • Two primary adaptive response patterns in the face of extreme threat are the hyperarousal continuum (defense -‐-‐ fight or flight) and the dissociation continuum (freeze and surrender response). Each of these response sets activates a unique combination of neural systems. 21
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