Three Ways Emotional Trauma Changes the Brain

By: Katie Honeywell, LPCMH, NCC

How does the brain change with trauma? The word “trauma” is becoming more familiar to the general population. Many people recognize the psychological impact of being in physical danger or witnessing someone being in danger. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition defines trauma in relationship to a near-death experience of oneself or a loved one (2013). However, you will hear the echoes from trauma therapists, that the existence of trauma is less about the content of the experience and more about the process of the nervous system. In other words, if the nervous system is overwhelmed, then it is trauma.

Let’s highlight a few examples of events that at face value may not seem life-threatening, but can be traumatic. Humans see the world through an individualized lens based on what we have experienced and learned thus far in life. We can look at Maslow's Hierarchy of needs for some guidance on threats of danger (Cherry, 2022). If a teenager perceives their social status to be in danger this may lead to a feeling of not belonging. From an evolutionary perspective, the sense of belonging to a village or group means our survival. If we are told by a parent that we are stupid and worthless, our love and belonging needs are not being met, and we descend to a sense of safety and acceptance.

With a quick internet search, one can have access to several scholarly articles, brain scans, and websites describing how emotional trauma changes the brain. Traumatic experiences activate brain mechanisms to ensure our safety. Depending on the conditions surrounding the event, things eventually return to normal and we go back to our brain's regular scheduled programming. However, if trauma continues, the brain can sustain long-term changes. Let’s break down a few key changes and their influence.

As our hypothalamus takes in experiences from our senses, our amygdala is provided with this information. If it deems the event as a threat, adrenaline pumps through our bodies, turning off our slower problem-solving prefrontal cortex to preserve energy. Our hippocampus, normally charged to encode logical information from the prefrontal cortex into long-term memory, shifts to producing cortisol, which is a pain-reducing chemical. If the brain continually experiences danger signals, lifelong changes can happen to the structure of the brain.

Here are just a few examples of how emotional trauma affects you. These changes are particularly important in understanding post-chronic trauma.

1. Research has found the amygdala is bigger for people who have experienced ongoing trauma (Geotakos, 2020). Clinical View: Danger signals are more frequent and get stronger until they’re heeded. Messages like “he is angry” or “they all hate me” flood through the brain quickly.
2. Images of the brain have found hypoactivity in the frontal lobe, anterior cingulate, and thalamic areas. The low thalamic activation impairs the functioning of several networks. Clinical View: Difficulty integrating adaptive information possibly causes people to feel guilt and self-blame for trauma (Giotakos, 2020).
3. Damage to the hippocampus and orbitofrontal cortex can prevent the encoding of information such as cognitive and autobiographical memory. Clinical view: This can dissociate memories from the prefrontal cortex preventing understanding and processing an event. In addition, a typical fearful event can cause the amygdala to perform a danger response, however, the person may present unimpacted because the affective circuits needed for the complete danger response are no longer connected (Giotakos, 2020).

There has been some attention to the overlap of brain changes between psychological trauma and post-concussion syndrome and traumatic brain injury (Shulman, 2020). I am excited to see the field of therapy collide with neurology. This is promising news for an Eye Movement Desensitization Reprocessing (EMDR) therapist. This therapy has been shown to produce activity in front-lobe activation (Giotakos, 2020). 

EMDR therapy is a bottom-up approach to healing mental health symptoms addressing the parts of the brain that are directly impacted by trauma like the prefrontal cortex, amygdala, and hippocampus. One goal of EMDR is to empower the client to connect adaptive information to stuck traumatic memories (Shapiro, 2017). If you are interested in learning more about the brain, trauma and EMDR consider taking our EMDR Basic Training Course. 

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References:

1. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
2. Bremner J. D. (2006). Traumatic stress: effects on the brain. Dialogues in clinical neuroscience, 8(4), 445–461. https://doi.org/10.31887/DCNS.2006.8.4/jbremner
3. Cherry, K. (2022) Maslow's hierarchy of needs, Verywell Mind. Very Well Mind. Available at: https://www.verywellmind.com/what-is-maslows-hierarchy-of-needs-4136760 (Accessed: November 14, 2022).
4. Giotakos, O. (2020). Neurobiology of emotional trauma. Psychoaatriki, 31(2), 162-171.
5. Shapiro, F. (2017). Eye movement desensitization and reprocessing (Emdr) therapy, third edition: Basic principles, protocols, and procedures. Guilford Publications.