How Trauma Changes the Brain: PTSD and Perception
PTSD, Trauma Survivors See the World Differently
If you’ve ever gazed up at the sky with a friend on a cloudy day, you likely noticed completely different shapes rolling by. Why is this the case, when we’re looking at the same clouds? Dr. Van Der Kolk claims that our experiences in life shape our perception of it–especially traumatic experiences. The things that happen to us in life manifest themselves physically and mentally, affecting our very outlook in ways we don’t realize.
Gone unaddressed, trauma can lead to PTSD. According to Jessica Bosecker, LMHC, “Post-Traumatic Stress Disorder is characterized by a host of symptoms, including intrusive thoughts about the trauma, distressing dreams related to the event, flashbacks, overall distress, physiological reactions to “triggers” that remind us of the trauma, avoidance behaviors around trauma reminders, negative emotions and cognitions, and behavior alterations, which include irritability, reckless behavior, hypervigilance, becoming easily startled, difficulty with sleep and concentration“.
Inkblot Testing Vietnam Veterans
The original 10 Rorschach inkblot test images had been used in psychology since the 20’s as a means of evaluating different aspects of a person’s mental state. Since the test had been in use for so long, common answers for each image had been established. For example, card II’s most common response is “two humans” or “a four legged animal”. Below, Van Der Kolk explains his surprising findings when showing this card to Vietnam Veterans. What do you see?
“When we gave the Rorschach test to twenty-one veterans, the response was consistent : Sixteen of them, upon seeing the second card, reacted as if they were experiencing a wartime trauma. The second Rorschach card is the first card that contains color and often elicits a so-called ‘color shock’ in response. The veterans interpreted this card with descriptions like “These are the bowels of my friend Jim after a mortar shell ripped him open” and, “This is the neck of my friend Danny after his head was blown off by a shell while we were eating lunch.” None of them mentioned dancing monks, fluttering butterflies, men on motorcycles, or any of the other ordinary, sometimes whimsical images that most people see. While the majority of the veterans were greatly upset by what they saw, the reactions of the remaining five were even more alarming: They simply went blank. “This is nothing”, one observed, “ just a bunch of ink”. They were right of course, but the normal human response to ambiguous stimuli is to use our imagination to read something into them. We learned from these Rorschach tests that traumatized people have a tendency to superimpose their trauma on everything around them and have trouble deciphering whatever is going on around them . There appeared to be little in-between . We also learned that trauma affects the imagination. The five men who saw nothing in the blots had lost the capacity to let their minds play. But so too had the other sixteen men, for in viewing scenes from the past in those blots they were not displaying the mental flexibility that is the hallmark of imagination.”
A New Understanding of Trauma, According to Mental Health America
Until recently, trauma survivors were largely unrecognized by the formal treatment system. The costs of trauma and its aftermath to victims and society were not well documented. Inadvertently, treatment systems may have frequently re-traumatized individuals and failed to understand the impact of traumatic experiences on general and mental health. Today, the causes of trauma—sexual abuse, violence in families and neighborhoods, and the impact of war, for example—are matters of public concern. Trauma survivors have formed self-help groups to heal together. Researchers have learned how trauma changes the brain and alters behavior. A movement for trauma-informed care has emerged to ensure that trauma is recognized and treated and that survivors are not re-victimized when they seek care. Complementing these changes are programs to promote healthy development of children and healthy behaviors in families, schools and communities that reduce the likelihood of trauma.
Facts at a Glance
- The Adverse Childhood Experiences (ACE) Study, an observational study of the relationship between trauma in early childhood and morbidity, disability, and mortality in the United States, demonstrated that trauma and other adverse experiences in are associated with lifelong problems in behavioral health and general health.
- More than 6 in 10 U.S. youth have been exposed to violence within the past year, including witnessing violence, assault with a weapon, sexual victimization, child maltreatment, and dating violence. Nearly 1 in 10 was injured.
- Predicted cost to the health care system from interpersonal violence and abuse ranges between $333 billion and $750 billion annually, or nearly 17% to 37.5% of total health care expenditures.
- A lifetime history of sexual abuse among women in childhood and adulthood ranges from 15 to 25 percent. An estimated 5 percent of males under the age of 18 experienced sexual victimization in the past year.
Treating The Mind-Body Connection
Van Der Kolk studied war veterans because the intense nature of combat-related trauma tends to magnify PTSD symptoms, making their changes in perception more measurable. However, in his work “The Body Keeps the Score” he ultimately makes a compelling case that we’re all carrying around mental baggage from unprocessed trauma we’ve experienced. As Van Der Kolk puts it, “Trauma is a fact of life…one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children“.
The good news? Addressing and processing trauma restores the mind and our outlook on the world. When PTSD symptoms are managed, once-traumatized people cease to ‘superimpose their trauma on everything around them’. If a person is able to put their past behind them, their creative faculties like imagination return to them. In other words, it isn’t too late to enjoy that cloudy day after all! Click here to learn more about promising new approaches to treating PTSD, such as EMDR Therapy.