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traumatic incident reduction

of Trauma

By Emily Spence Diehl, MSW

Associate Director, Victim Advocacy Center
Florida International University

(Originally published in the Florida Council of Sexual Abuse Services newsletter)

In 1889, researcher Pierre Janet philosophized that traumatic memories are stored differently in the brain than other types of experiences. He believed that traumatic memories are stored more as emotions and senses than as cognitions. Unfortunately, medical technology in the late 1800's was not as advanced as Janet's thoughts and beliefs. Since the early 1990's, an incredible amount of fascinating psychobiological research has begun to shed light on the physiological experience of trauma. If Pierre Janet were alive today, it is certain he would rejoice in the medical "proof" now available to support his theories.

To fully understand the physiological impact of trauma, it is important to review the body's emergency chemical responses and memory functions.

Emergency Response: During any type of trauma, neurotransmitters in the brain set off the release of a series of chemicals:

With "normal" amounts of stress, these chemicals facilitate a process that allows people to function with greater endurance, strength, immunity, and clarity. In extreme amounts of stress, however (rape, domestic violence, and other forms of victimization), these chemicals may often be released in amounts that are damaging to the brain and inhibit memory functions.

This leads us to the consolidation of traumatic memories. Our brains utilize two types of memory:

Research now indicates that high levels of norepinephrine, epinephrine, and endogenous opioids interfere with the storage of explicit (declarative) memory. Therefore, traumatic memories are stored in the implicit form, as emotions and senses. As practitioners, we have become accustomed to our clients remembering their experiences in pieces, and virtually "shutting down" as they attempt to re-tell their stories. Survivors become haunted by feelings and senses they know are related to the trauma, but have great difficulty clearly identifying the source(s). This promotes a vicious cycle in which the body is unable to assess danger signals and reacts to any direct or indirect reminder of the trauma as a potential re-victimization, even if the reminder is completely non-threatening. These triggers bring overwhelming emotions and sometimes flashbacks and panic attacks which in-turn cause the body to return to the emergency chemical response. These continual "flight or fight" reactions bring base-level psychobiological changes:

Additionally, preliminary research of trauma survivors has shown they have a reduction of their hippocampal volume (memory passageways) ranging between 5 and 18%. The hippocampus is a small, seahorse shaped section deeply embedded in the brain; it is responsible for managing and integrating declarative (explicit) memory functions. This reduction not only affects survivors ability to recall the trauma in an integrated and clear manner; their regular memory functions (short-term memory and reasoning abilities) may be impaired as well.

Is there hope for recovery? The good news is YES! There are pathways out of the cycle of psychobiological trauma triggers. One of our goals in working with survivors should be to assist them to integrate their memory functions so that they can recall the trauma verbally and lessen the immobilizing emotional/sensory responses. There are some excellent new techniques available that seem to accomplish this: TIR (Traumatic Incident Reduction) and EMDR (Eye Movement Desensitization Reprocessing). TIR is especially important since it can be practiced by non-licensed individuals, is completely client-centered, and has almost no risks when practiced correctly. EMDR requires that the practitioner be licensed or license-eligible and must be used carefully as part of a comprehensive treatment plan. Additionally, survivors can do any or all of the following to promote their own recovery process:

Because this information is so new, we are constantly gaining further insights into the understanding and treatment of trauma survivors. Dr. Bessel van der Kolk, has written several excellent reviews of the literature, one of which is entitled "The Body Keeps the Score: Memory and the Evolving Psychobiology of Post-traumatic Stress ". A great deal of information is regularly updated on the Internet; Dr. Charles Figley's electronic Journal of Traumatic Stress is extremely informative.

Those who share my excitement in this knowledge are welcome to contact me for further resources.