What is trauma? Trauma encompasses physical abuse/violence, sexual violence/abuse, and neglect. It is also stalking, kidnapping, harassment, bullying, witnessing crime, even divorce and custody battles. The stress-trauma continuum runs from normal, to situational, to traumatic. Perceptions and expression of trauma encompased in one’s gender and culture and forms as psychological, somatic, and spiritual.
To view trauma, one must think conceptually. Trauma is a neurophysiological state that comes from a neurobiological injury. This concept of trauma has evolved in recent research on the human brain and how trauma impacts our brain. As Peter Levine states, we must understand that trauma is physiological as well as psychological in order to effectively provide treatment.
The impact on behavior from trauma is well known:
- substance abuse/dependency to cope with hyperarousal, panic attacks, nightmares, insomnia, numbness, and flashbacks.
- indiscriminant sexual behavior
- self-harming behavior such as cutting and burning oneself, and suicidial gestures and attempts. (13%-25% in adolescents, 11% of college students, middle-school has a higher prevalence and is the age at which most individuals initiate self-injury)
- continued contact with the abuser.
- freezing and immobilization in the face of violence.
- engaging in other high risk behaviors.
Some interesting facts from a study by DeBellis from the University of Pittsburg. By studying the brains of children with histories of abuse and diagnoses of PTSD and compared them with healthy children who had not experienced abuse.
- abused children excreted greater amounts of cortisol and catecholamines than non-abused children
- abused children had 7-8% less cerebral volumes which leads to imparing memory and dysregulating arousal.
- neurons enlarge with age and axons thicken – which impacts brain size during development
- the corpus callosum of children with PTSD did not grow with age compared to those without PTSD, which may be due to a failure of myelination.
- Trauma disrupts dopamine, which is needed to increase judgement and impulse control,
- brain hemisphere integration is effected, impairing rational thought vs overwhelming emotion
Why do people self-injure?
- to exert self-control or punishment
- as a distraction from emotional pain
- to get attention
- to attain group membership
- to unconsciously rebalance brain chemistry
- to evoke emotion when feeling numb (up regulation)
- to stimulate a high
- self-harm activates the endogenous opiod system (EOS) which regulates pain and releases endorphins, adrenaline and dopamine to promote calm and well-being
- low serotonin is correlated with suicide attempts, aggression, and impulsivity.
Overall, any trauma during birth to age 25 has the potential to contribute to long-term consequences. Chronic abuse and multiple truamas have a greater neurobological impact.
Strategies that help: a therapeutic response, a helping relationship, a safe relationship, positive attachments, importance of empowerment, visuospatial tasks, continuing to learn new things.
Information from presentations by Janine D’Anniballe, Peter Levine, DeBellis