Out of the Mire

I have recently been reading a lot of material on the endocrine system and neurology.  Why? Anatomy and Physiology II.  Brain, brain, brain, brain.  What I’ve learned, aside from more than I ever expected to know about hormones, is that distress of all kinds is really bad for the body.  Really bad.  It is chemically bad.  Our bodies secrete so many chemicals in response to real and perceived stressors, and prolonged exposure to those chemicals do damage to our vessels and surrounding tissues–to our brains.  We are not meant to marinate in our adrenal gland’s hormones, but we do.  More and more.  What is one stressor that might cause said marination? Trauma.  And, that trauma can be early childhood or yesterday’s car crash.  Time isn’t a factor.

Outside of A&P II, I’ve been reading about trauma and the brain because I want to find some answers to my own questions.  I came across a quote online somewhere a few days ago that said that trauma is an “unfinished event”.  Initially, I did not like this interpretation of trauma.  An unfinished event? What does that mean? It bugged me all week.  Then, I heard it again this morning! I was watching an explanatory video on The Hakomi Method in which Ron Kurtz, founder of the method, was illustrating a point by discussing a session he had with a client.  His client had an experience in session in which he recalled being hit by a car and waking up in the hospital with a priest performing something like a blessing or even the last rites over him.  He was consequently filled with dread in the past and in the present as he recalled it.  Kurtz explained that his client was experiencing an unfinished fear.  He had never had the opportunity to fully process that experience–or finish it.  So, the client’s wife, who had been present in session, held him in order to soothe and console him while Ron talked him through the rest of the experience.  His client finished experiencing his trauma in order to finish experiencing his fear.  He processed that trauma.  I was intrigued and emotionally stirred.

Dr. Mark Brady describes the early phase of recalling traumatic memories as such:

“Extensive research suggests that early terrifying experiences take up residence in implicit (unconscious) memory networks primarily on the right side of the brain. These memories essentially compromise the flow of electro-chemical energy and information. In response to overwhelming experiences, our neural networks abruptly inhibit the firing of action potentials (nerve impulses) in the brain so as to cause the adrenal glands to stop flooding both brain and body with excessive amounts of adrenaline, noradrenaline and cortisol. In the amounts generated by life-threatening emergencies, without this safety shutoff, that quantity of stress hormones would do even worse damage than the trauma itself. The lived experience feels like going numb or being checked out – dissociated. But that’s not the end of it.” (“When Terror Strikes for No Reason”)

I am all too familiar with this experience.  Does it resonate with you? When I recall past trauma that has not been processed, this is exactly what I feel like.  I have, in the past, mistaken my numbness or emotional detachment for being completely fine.  I used to think that it meant that I was presently okay with whatever happened way back when.  Hardly.  Dr. Brady is describing the “back end” of your emotional and affected experiences.  The inner workings of your mind.  Whether you know it or not, your brain is your friend.  It is the modulator of your emotional experiences.  It allows you to recall and cognitively experience a memory, but it’s not going to allow you to experience the emotional contents of said memory at the same time–unless you go mining and break into buried compartments.  In other words, your brain is trying to titrate your emotional experiences so that you are not overwhelmed or overdosed by your own traumatic experiences.

Brady goes on to say:

“The brain knows when its functioning has been compromised by traumatic experience. As a consequence it seems to constantly attempt to identify or morph people, places and familiar environments into circumstances where its impoverished networks can be rekindled and activated, ideally for integrative re-connectivity. In both the incidents I’ve just described, that didn’t happen. Abdication (flight) is not integration.” (“When Terror Strikes for No Reason”)

The aforementioned remark is absolutely vital to me in terms of understanding ourselves and creating a roadmap out of our suffering.  What do I mean by this? Take a moment to consider your uniquely personal Distortion Machine.  What is the Distortion Machine? It is the name I’ve given to that harassing voice inside your mind that never shuts up.  It is the Malicious Storyteller.  It is the voice that always says, “What if…what if…what if…” followed by hundreds if not thousands of possible detailed scenarios usually involving your downfall.

• “What if you trust this person and they betray you just like everyone else you’ve trusted?”
• “What if you try your hardest and fail?  Again.”
• “What if your house is struck by lightning and burns to the ground?”
• “What if you never meet anyone and you die all alone and they find your body all decayed and partially eaten by your cats?”
• “What if you really do look terrible in those pants and no one has the balls to tell you because everyone just feels sorry for you because they all know that you will never meet anyone and will most certainly die alone and will for sure be eaten by your cats?”
• “What if you’re just stupid?”
• “What if your parents were right about you all along?”
• “What if it was really all your fault?”
• “What if you really do have a snaggle tooth?”
• “What if no one really likes you at all?”
• “What if you choke and you’re by yourself and you can’t give yourself the Heimlich maneuver and you die…once again to be found partially eaten by the neighbor’s Great Dane.  Or…just your cats?”
• “What if you get in a terrible car accident because someone is texting while driving?”
• “What if he decides he doesn’t want you anymore? Out of the blue? And you don’t see it coming? What if you can’t adapt to that? What if something terrible happens and it finally breaks you? What if…you just can’t get up again…?”
• “What did she mean about you when she said that? What if she is looking for a way out of this relationship?”

Do you notice the mix of absurdity, fear, and preoccupation with the past that paves the road into your future? The past is informing the present which kindles anxiety and fear about what might happen in the near or distant future? Some of this seems absolutely far-fetched.  Lightning striking a house? Being eaten by cats? Choking to death? Car accidents? These are all examples of cognitive distortions that fall under the heading of catastrophizing, and I do this all the time.  My brain is usually set off when I’m relaxed and happy.  It’s as if it cannot stand to be at peace, and I cannot stand that my brain must kill off my serenity.

For example, if I get my hair done and it looks good, then I usually hear something like: “What if it all falls out? What if you get cancer and have to have chemotherapy and lose all your hair?” When I have a good coffee date with a friend, I might hear, “What if they get tired of you? What if they find out how weird you are?” I am left dragging my self-esteem and bedraggled brain home feeling like this:

Why does this happen? I have an answer (sort of), and it begins and ends in your brain.  The first thing to understand is that our brains do not live in the past.  I thought that mine did.  I was wrong.  Our brains live in the future.  Our brains are continually looking for patterns based upon past experiences in order to predict outcomes so that we might have a sense of what to expect which allows us to plan a trajectory with a reasonable amount of certainty.  Our brains do this all the time with very few data points without your conscious input.  Also, our brains fill in the gaps between those data points with whatever is available be it past, present, or available data.  In other words, our brains make shit up, and we are completely unaware of this.  We are operating on false premises most of the time, but this is a necessary evil because we would not be functional or decisive if our brains failed to do this.

Think of all the unknowns that surround us second-to-second.  Is that coffee too hot to drink? Did that barista really put almond milk in my latte? Was that really a car backfiring, or was someone shooting a gun? Should I cross the street, or will a car careen out of control from out of nowhere and run me down? Is that dog friendly? Are all these strangers safe? Is there E. coli in my spinach leaves? Should I drink this water? How do I know that someone in this movie theatre isn’t concealing a weapon? How do I know that someone didn’t lick that penny that I just picked up off the ground? We are faced with too many decisions to consider on a daily basis.  Our unconscious brain must act for us all the time in order for us to maintain higher functionality–just to make it through the day.

Enter outlier events.  When you have trauma in your past, your trauma becomes a data point for your brain, but traumatic events should be logged under “outlier events”.  In other words, traumatic events should not be considered viable data points when your brain is constructing its premises and making its decisions.  Think of statistics.  How do we calculate an average? Before we calculate an average, we throw out the outliers: the highest number and the lowest number.  Then, we calculate our average.  Past traumatic events in our lives are part of the outlier numbers–the highest and lowest numbers.  Outside the bell curve if you will.  You cannot consider them as a possible data point for a future set of possibilities, and yet our brains do this all the time.

This is why my brain is the Malicious Storyteller.  The majority of my past events are highly traumatic.

• “What if he turns out to be a liar and dupes you?”
• “What if he tries to kill you?”
• “What if you die in a terrible accident?”
• “What if everyone leaves you?”
• “What if it’s really true about you? What if you are disposable?”
• “What if you get eaten by a wild animal while you’re still alive?”

I know that all of these sound ridiculous, but all of the aforementioned “What ifs…” have happened to me.  I have been duped.  I have almost died in a car accident.  I have been threatened with being eaten alive by wild animals while in the trafficking environment.  I have been tortured.  I have been abandoned and left to fight for my life.  I was young, and these events happened years ago.  These are all outlier events, but my brain does not know that.  To my brain, these are all data points.  These are legitimate possibilities that must be considered.  Some of these old traumas became new again in my marriage during re-traumatization.

Enter the habenula.  What is that? The habenula is part of the diencephalon and, together with the pineal gland, makes up a structure called the epithalamus.  It is a tiny mass of cells about the size of half a pea.  “The habenula tracks our experiences, responding more the worse something is expected to be,” said senior author Dr. Jonathan Roiser of the UCL Institute of Cognitive Neuroscience.”  (Medical Daily) .

The habenula is involved in many, many of your brain’s activities, but it really gets involved when your brain starts storytelling and predicting.

“Previous neuroscience studies have shown how animals will exhibit avoidance behaviors following activity in their habenulas. Researchers watched as cells fired within animals’ habenula whenever bad things happened, or were simply anticipated to occur. Activity in this region is known to suppress dopamine, a neurotransmitter that helps regulate our brain’s reward and pleasure centers. Dopamine not only enables us to see rewards, but also to take action and move toward them. Significantly, the habenula has also been linked to depression.

For the current study, the researchers began by enrolling 23 healthy volunteers. First, participants were positioned inside a functional magnetic resonance imaging (fMRI) scanner, while the researchers collected brain images of high enough resolution to capture activity in the tiny habenula. Then, volunteers observed a random sequence of pictures, with each followed by figures depicting the chance of a good or bad outcome. Occasionally, volunteers pressed a button simply to show they were paying attention. Watching, the researchers discovered how habenula activation tracked the changing expectation of bad and good events. In particular, Roiser noted how the habenula didn’t just express whether something would lead to a negative event or not, it also signaled (with its increased activity) “how much bad outcomes are expected.” (Medical Daily)

Now, with that in mind, take a look at this study.  Put on your thinking hat:

“Under repeated or continuous stress, animals and humans may show depression-like behaviour, as proposed by the ‘learned helplessness theory’⁶⁴ and the ‘rank theory’¹¹² of depression. In both schemes, depression is considered to be a form of behavioural adaptation to adverse conditions. More importantly, in the state of depression sensitization of the LHb-dopamine and LHb-serotonin circuits seems to occur (FIG. 2c). Indeed, in humans with depression and in animal models of depression the LHb (lateral habenula) becomes hyperactive^12,83. This may cause the general motor suppression (through inhibition of dopamine neurons) as well as the mood changes (through changes in serotonin transmission) that are associated with depression.

Thus far, I have proposed that the habenula evolved as a general motor controller that was originally devoted to circadian control of behaviour. According to my hypothesis, at some point in evolution the brain areas that encode aversive signals acquired connections to the habenula. The habenula then became a suppressor of motor activities in response to, or in anticipation of, aversive events.” (The habenula: from stress evasion to value-based decision making)

What does all this mean?

“The researchers believe their study suggests how a hyperactive habenula might cause people to make disproportionately negative predictions, while also being involved whenever people feel pessimism and low motivation, or when they focus on negative experiences.” (Medical Daily)

What do I think this is? I suspect that this is a form of learned helplessness (LH) due to past exposure to trauma in which the victim of trauma had no control over the trauma and no means to escape the trauma.  There are numerous studies available for review on LH (search PubMed).  Clinicians are trying to assess how to help victims of trauma overcome LH as well as study the etiology of LH.  LH perpetuates depression, and perceived re-traumatization exacerbates LH in those with PTSD even when there is a means of escape and control over the duration and exposure to the trauma.  Based upon the animal studies, coping style and personality can often determine how one deals with later exposure to trauma or reminders of past trauma.  In addition to this, the neurochemistry of the brain is changed sometimes for the worse after trauma exposure hindering recovery.

Okaaaaay, but how can I make this practical? I like knowing what is happening in my brain.  It helps me feel better about myself for some reason.  My brain is just doing what it was designed to do (or getting in my way).  That being said, now what? What can I do to help myself?

• Shut it down.  The Storyteller has nothing good to say.  It’s like listening to a maniacally deluded weatherman predict the weather:

  

  “Run! Get inside! It will be raining fire and dragons! FIRE! DRAGONS! RUUUUUUN!”

• Find and activate your imagination by bringing forth colors, music, scenes, and images that you like whenever you begin to hear the Storyteller’s voice. For some reason, the imagery that you choose to conjure which springs forth from the right hemisphere of the brain can often overpower the words of the Storyteller, which you didn’t choose.  This actually works.
•  Change your language.  Stop referring to what caused your PTSD as a trauma.  Start using the word ‘injury’.  You were injured after all.  You do not have an illness.  You have an injury, and you are engaged in a process to heal from that injury that you received by no fault of your own.  You might be surprised at how effective this one linguistic change can be.
• Change your perspective.  “One of the keys to Time Perspective Therapy is the realization that we always have the choice to change how we view the times of our lives. Over the course of Time Perspective Therapy, PTSD sufferers move away from a narrow focus on the traumatic past and a cynical present and the possibility of ever achieving a hopeful future. Instead they journey toward a balanced time perspective in which it seems possible once again to live a full and promising life.This concept is reflected in ordinary language that time perspective therapists use. Most people suffering from PTSD have already been labeled as anxious, depressed, or even mentally ill. When they hear these words, and identify with them, the possibility of ever emerging from such a state feels very distant. Reframing their ‘‘illness’’ as an ‘‘injury,’’ and recasting their depression and anxiety as a ‘‘negative past’’ that they can replace with a ‘‘positive present’’ and ‘‘brighter future’’—and ultimately with a balanced time perspective—may seem overly simplistic, especially to those trained in psychotherapy. But to PTSD sufferers, the idea of having a forward-leaning framework in which to understand and work on their issues most often comes as an enormous relief and a welcome ray of light in the darkness.  The image below illustrates how in Time Perspective Therapy (TPT), we show people how to lift their back foot that is stuck in the muck and mire of the traumatic past while standing firmly on the ground of the solid present, and place it into a brighter future.” (Your Brain on Trauma)
  

  Source: Noah Milich

  So, there it is.  There is so much happening in our brains all the time, and we don’t even know it.  We can, however, make small changes when we feel well or even relatively okay to create habits that will make all the difference when we don’t feel well.  When the Storyteller comes for us.  When it starts raining fire and dragons and Paradise is lost.  Or, at least, when it feels that way.  So, the next time you feel adrift, panicked, and awash in “What ifs”, remember your habenula.  Remember to throw out your outliers before you let your Storyteller even try to calculate potential outcomes.  And, don’t forget to activate your imagination and silence your verbal processing.  Take in some beautiful images and music to silence that Inner Torquemada and overcome that sense of learned helplessness.

  

Is it a tall order? Maybe.  But, every tiny effort is still an effort.  Be proud.

Keep going.

MJ