The Imprint of Trauma: Chapters 11 and 12 of The Body Keeps the Score

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The Imprint of Trauma: Chapters 11 and 12 of The Body Keeps the Score Lois A. Ehrmann PhD, LPC, NCC Certified EMDR Consultant; Certified IFS Clinician Certified Attachment Focused Family Therapist Certified in Clinical Hypnosis & Trained in Neurofeedback Founder and Executive Director The Individual and Family CHOICES Program 2214 North Atherton Street, Suite 4 State College, PA 16803 (814) 237-0567

Learning Objectives By the end of this presentation participants will: Identify at least two differences between normal memory recall and traumatic memory recall and why distinguishing them is so important in the treatment of PTSD. Describe at least three ways in which our traumatized clients show us how they have been traumatized.

Normal Versus Traumatic Memory Where were you and what were you doing on Tuesday September 11 th, 2001?

And Then. Where were you and what were you doing on Monday September 10 th, 2001?

Whether or Not We Remember ANYTHING Depends Upon: 1. Personal meaning 2. Intensity of emotions 3. Level of arousal

Things out of the ordinary (schemes and Maps) are remembered better We have a day where everything goes wonderfully and the events hour to hour flow effortlessly except for one hour where an argument ensued with a colleague (or a client or a supervisor or the person giving you a parking ticket) and what do we remember the most? Because we remember insults and injuries best: the adrenaline that is secreted to defend against potential threats helps to engrave those incidents into our minds.

Increased adrenaline = increased accuracy in memory..up to a point If exposed to horror and inescapable shock.(like when brutally terrorized as a child) this system located in the rational brain areas becomes overwhelmed and breaks down In the laboratory when fragments of the original trauma are activated brain scans show the frontal lobe shuts down including the region of the brain that puts feelings into words.when there are no words When the rational brain goes offline and the emotional brain, not under conscious control, steps up the plate: High arousal changes the balance between the rational brain and the emotional brain and fight flight freeze gets activated. High arousal disconnects other brain areas (hippocampus and thalamus) needed for the proper storage and integration of incoming information. So how are the recollections of trauma imprinted in the brain?

Imprints of Traumatic Experiences are Not organized as coherent logical narratives but in fragmented sensory and emotional traces: Images such as.. Sounds such as.. Physical sensations such as.. Smells such as.. What is missing is the story (narrative) that goes along with these.

Looking for Trauma in All the Wrong Places. The story doesn t make sense but the body really tells the truth. Charcot studying hysteria (the root was trauma) Janet proposed that at the root of what we not call PTSD was the experience of vehement emotions or intense emotional arousal. Narrative memory versus traumatic memory Case studies looked at trance like states, dissociated memories and reenactment and the triggers that activated them Dissociation= splitting off and isolation of memory imprints in a traumatic event Freud and Breuer devised the Talking Cure (1983) page 181 quote Recollection without affect attached has no healing effect

Trauma Rediscovered The Courage to Heal (1988) Trauma and Recovery (1992) Judith Herman Early 1990 s False Memory Syndrome

Repressed Memories Do they exist? Yes!! but once remembered and processed the memory changes. The human brain must make sense of the senseless.

The Study done of Normal Versus Traumatic Memory Normal Memories Are organized Physical sensations are present Have a beginning middle and end Traumatic Memories Disorganized Some details remembered too much like smells Could not recall the sequence of the events

Additional Findings Traumatic memories are fundamentally different from the stories we tell about the past. They are dissociated in that the different sensations that entered the brain at the time of the traumatic event(s) are not properly assembled into a story or a piece of autobiography. Remembering the trauma with all its associated affects does not necessarily resolve it. This was different than what Breuer and Freud found. Language (The Talking Cure) can not always substitute for action. Even when study participants told the whole story and got the sequence right they were still haunted by triggers and images and flashbacks. Has implications for the exposure strategies of CBT interventions.

Can we Listen to Survivors? Page 194 We all want to live in a world that is safe, manageable, and predictable and victims remind us that this is not always the case. In order to understand trauma we have to overcome our natural reluctance to confront that reality and cultivate the courage to listen to the testimonies of survivors.

And Finally During this Holiday Time.. May you find calm in the chaos of the season May you find peace if your heart stirs with the struggle of the season And May you find healing in your Self and with Others if hurt is part of the reason