Trauma: The Right-Brain Connection

Excerpted from
Invisible Heroes: Survivors of Trauma and How They Heal
By Belleruth Naparstek

Brain development expert Bruce Perry has studied how a traumatized brain is compelled to train its focus away from language and verbal content, and to fix instead on nonverbal danger cues-body movements, facial expressions, tone of voice, and the like, searching for threat-related information. Cognition and behavior are mediated by the more primitive parts of the brain-the brain stem and midbrain - at the expense of abstract thinking and the absorption of language and ideas. Only when sufficiently calmed can attention be focused on ideas and the meaning of words.

This is why interventions that are based on a strictly cognitive, problem-solving approach cannot impact terror-driven behavior. The primitive brain and midbrain cannot process cognitive solutions aimed at the higher cortical functions. But imagery, with its calming voice tones, soothing music and symbolic representations of safety, can settle down hypervigilant brain functioning and allow the higher brain to get back to doing its job.

PET scans and recent research have shown how traumatic events leave distinctive footprints on the brain, making survivors far more amenable to imagery than they were before the trauma. Sufferers of acute and post-traumatic stress experience exaggerated sensitivity and heightened reactivity in the parts of the brain that process emotions, sensations, and images-the amygdala and its surrounding neuronal network. As a result, trauma survivors are exquisitely responsive to sensations, emotions, and perceptual cues. Of course, this is what makes up the very essence of imagery, both its content and its style. Guided imagery is thus an intervention of choice, a best practice that is perfectly geared to take advantage of that which is most accessible in the wiring of a survivor.

On the other hand, Broca's area-the part of the thinking brain that translates personal experience into language-loses capacity as a result of a trauma, at least temporarily. This is why people under acute traumatic stress experience their emotions as physical states rather than as verbally encoded happenings.7 The person sees, hears, and feels fragmented sensory elements of the traumatic event but is hard pressed to translate them into communicable language. When asked to describe an actual traumatic episode, a survivor is often rendered speechless (literally) because of these physiological impediments.

Because the survivor is hindered in her ability talk about the event, organize it into a conceptual framework, or integrate it into her life experience, the usual methods of digesting what has happened through discussion are often inadequate. Words and the "talking cure" are not the promising vehicle for healing that they would normally be under different circumstances.

A certain number of long-term trauma survivors find themselves with yet another hindrance to using the analytical side of their brain. Chronic, severe elevation of stress hormones can result in some shrinkage of the hippocampus - the part of the brain that compares new information with past associations and quickly decides whether something is good or bad, safe or dangerous. As a result, the ability to see things in context and make critical distinctions can suffer, at least in the more extreme cases, while impulsivity and disinhibition can be exaggerated.

The survivor needs to use the best assets at hand to help with healing, and under these circumstances, the thinking part of even an extraordinarily fine mind is not necessarily a shoo-in for first choice. What a survivor does have in abundant supply, however, precisely because of his traumatic experience, is his supersensitive, hyperacute, pumped-up, spring-loaded, and downright athletic right hemisphere. These overfunctioning visual, sensory, and emotional channels of the brain make for a powerful natural healing alliance. As Cleveland-area psychotherapist Linda Gould. L.P.C.C., says:

Oftentimes in trauma, healing cannot be completed because traumatic experience becomes locked in various areas of the brain. We don't work trauma through by just talking about it. Talking is primarily a left hemisphere activity. In order to complete the healing process, a traumatized person must access the limbic system and the right hemisphere of the brain, where images, body sensations and feelings are stored. By activating this area of the brain and accessing the stored images, body sensations and feelings, a person is able to attach meaning to them and move this traumatic material to more adaptive resolution.

The changes in the neuronal network of a traumatized person make for extreme responsiveness to direct contact with the experiential self, through avenues of sensation, perception, and emotion. In this way the gentle but potent ministrations of guided imagery become a powerful treatment of choice.

Rebalancing Biochemistry

Trauma survivors experience extreme swings in their biochemistry, from the jolts of Cortisol, epinephrine, and norepinephrine that accompany flashbacks, nightmares, and intrusive memories, to the body's built-in pharmacy of relaxants and endogenous opioids. Most of the time the body rebalances on its own after a traumatic event, returning to normal homeostatic business as usual within a few weeks or months.

Most people, however, experience at least several weeks immediately following a traumatic event when their systems are stressed and out of balance, and when Cortisol levels are significantly, abnormally elevated. This is the biochemical counterpart to feeling anxious, hypervigilant, angry, tearful, panicky, upset, irritable, fearful, rageful, or terrified.

Should these symptoms become chronic over several years, the survivor runs the paradoxical risk of then chronically underproducing Cortisol, with depressed levels that are punctuated now and then by occasional alarm states that shoot it through the roof. Suppressed Cortisol is usually associated with depression, numbness, joylessness, emotional flatness, inaccessibility, fatigue, listlessness, dissociation, and disconnection.

When chronically dysregulated stress hormones infuse the bloodstream for an extended period of time, they can wear away heart muscle, block arteries, create muscle pain, initiate immune and autoimmune problems, and shrink specific areas of the brain. As luck would have it, however, imagery and allied forms of meditation are proven strategies for gently and nonintrusively steering the body's biochemistry back into balance.