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 with Broca's aphasia can still read and understand spoken language, but has difficulty speaking and writing. • There is a region in the left temporal lobe called Wernicke's area. Damage to this area causes Wernicke's aphasia. An individual can make speech sounds, but they are meaningless (receptive aphasia) because they do not make any sense. • American Association of Neurological Surgeons • How the brain is altered by the traumatic experience. All experience changes the brain – good experiences like piano lessons and bad experiences like living through a tornado as it destroys your home. This is so because the brain is designed to change in response to patterned, repetitive stimulation. And the stimulation associated with fear and trauma changes the brain. Over the last twenty years, neuroscientists studying the brain have learned how fear and trauma influence the mature brain, and more recently, the developing brain. It is increasingly clear that experience in childhood has relatively more impact on the developing child than experiences later in life. This is due to the simple principles of neurodevelopment. The functional capabilities of the mature brain develop throughout life, but the vast majority of critical structural and functional organization takes place in childhood. Indeed, by the age of three the brain has reached 90 % of adult size, while the body is still only about 18 % of adult size. By shaping the developing brain, experiences of childhood define the adult. Neurodevelopment is characterized by: (1) sequential development and ‘sensitivity’ (the brain "grows" from brainstem to the cortex) (2) ‘use-‐dependent’ organization ("use it or lose it"). The mature organization and functional capabilities of brain reflect aspects of the quantity, quality and pattern of the somato-‐sensory experiences of the first years of life. The sequential and use-‐dependent properties of brain development result in an amazing adaptive malleability, ensuring that, within its specific genetic potential, an individual’s brain develops capabilities suited for the ‘type’ of environment he or she is raised in. Simply stated, children reflect the world in which they are raised. If that world is characterized by threat, chaos, unpredictability, fear and trauma, the brain will reflect that by altering the development of the neural systems involved in the stress and fear response. 2
Handout for Trauma, The Developing Brain, Healing and Emotional Regulation Seminars Karina A. Forrest-‐Perkins MHR LADC, 2011 The Neurobiological Responses to Threat When a child is threatened, various neurophysiological and neuroendocrine responses are initiated. If they persist, there will be ‘use-‐dependent’ alterations in the key neural systems involved in the stress response. These include the hypothalamic-‐pituitary-‐adrenal (HPA) axis. In animal models, chronic activation of the HPA system in response to stress has negative consequences. Chronic activation may "wear out" parts of the body including the hippocampus, a key area involved in memory, cognition and arousal. This may be occurring in traumatized children as well. Dr. Martin Teicher and colleagues have demonstrated hippocampal/limbic abnormalities in a sample of abused children. Another set of neural systems that become sensitized by repetitive stressful experiences are the catecholamine systems including the dopaminergic and noradrenergic systems. These key neurochemical systems become altered following traumatic stress. The result is a cascade of associated changes in attention, impulse control, sleep, fine motor control and other functions mediated by the catecholamines. As these catecholamines and their target regions (e.g., amygdaloid nuclei) also mediate a variety of other emotional, cognitive and motor functions, sensitization of these systems by repetitive re-‐experiencing of the trauma leads to dysregulation in many functions. A traumatized child may, therefore, exhibit motor hyperactivity, anxiety, behavioral impulsivity, sleep problems, tachycardia and hypertension. In preliminary studies by our group, we have seen altered cardiovascular regulation (e.g., increased resting heartrate) suggesting altered autonomic regulation at the level of the brainstem. In other studies, clonidine, an alpha2 adrenergic receptor partial agonist has been demonstrated to be an effective pharmacotherapeutic agent, presumably by altering the sensitivity of the noradrenergic systems. Implications of Trauma-‐related Alterations in Brain Development All experiences change the brain – yet not all experiences have equal ‘impact’ on the brain. Because the brain is organizing at such an explosive rate in the first years of life, experiences during this period have more potential to influence the brain – in positive and negative ways. Traumatic experiences and therapeutic experiences impact the same brain and are limited by 3
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