Originally posted June 2, 2020.
Advances in neurobiology – knowing how our brains and nervous systems work – help us understand how PTSD symptoms persist and also how they can heal. The healing of PTSD symptoms is often called, or accompanied by, a phenomena known as post-traumatic growth (PTG).
In PTSD: No, it’s not all in your head, we looked at the diagnosis and symptoms of PTSD, and listed some of the biological underpinnings – the brain and body changes – of PTSD.
In this post, we look at some of the biology of the PSTD. We have a brain and body – a real, physical – platform – a neurobiological platform – that is the basic foundation of our emotional reactions.
We’ll take a look at two properties of our neurobiological platform that are important to understanding the persistence of PTSD symptoms and valuable in healing PTSD: neuroplasticity and neuroception.
We’ll look at why PTSD carries so many disparate and persistent symptoms over a lifetime. And why do these symptoms seem outside of our conscious control? The concepts of neuroplasticity and neuroception, help explain our implicit – below awareness – emotions and behaviors.
Neuroplasticity: Can freeze us in the past and can be harnessed for therapeutic effect
Neuroplasticity refers to the brain’s capacity to create new pathways and adapt old pathways in response to new experiences. In other words, the brain actually physically changes when learning and experiencing new things. Through current technology, we are able to actually view neurogenesis, which is the creation of new neurons and the bundling of multiple neurons. It’s now accepted that the brain and nervous system are constantly influenced and changed, based on our experiences.
Neuroplasticity is most rapid during the first few years of life, as the infant and toddler learn about their world. The connections that are most used will strengthen and the connections that not used frequently, weaken.
One of my favorite neuroscientists, Carla Hannaford, says, “Learning is a strengthening connection between neurons.” (Her book Smart Moves expands on this concept extensively.)
Our individual neurobiological platform is shaped over time. We develop ingrained habitual responses based on our experiences, which directly shape our neuronal programming.
Patterns of neurons that are used often, actually reach out towards each other and connect via electrical impulse along their axons. The most used connections are strengthened via a process called myelination. Myelination is a complex process where a fatty substance sheathes the neuronal axons that allows the axons to transmit information very, very fast. So, all the neurons that go into, say, the skill of driving are actually physically tightly bound together via myelination.
During adolescence, a massive pruning process among the neuronal connections takes place. The neurological underpinnings of the most used responses, skills and behaviors are saved and the neurobiological underpinnings of the least used responses, behaviors and skills are pruned back. This is intended to make the organism/person more efficient. The pruning process also “bakes in” our most used responses … whatever skills we used most in our early lives (reading, writing, knitting, car repair, etc.). And this is true for our emotional skill set as well.
Imagine the abused and neglected child. His world is chaotic, frightening and physically painful. His neurological platform is set to expect fear, anger, despair and pain. As a teenager, pruning takes place, hardening the early fear patterns.
This paints a sad and discouraging picture for any hope in developing a healthy, loving and kind self. If the abused child doesn’t have a past set of choices of emotion and action upon which to draw, a painful pattern of fear, aggression and immobility can occur.
However, there is hope. Our ability to learn and grow – our biology – the amazing neuroplastic brain and nervous system – is part of our ability to adapt and change. We know for a fact that learning takes place over a lifetime.
Neuroplasticity can be harnessed for therapeutic effect, using specialized treatment options that target creation of new connections that contribute to embodied feelings of a positive and strong self.
Targeted somatic therapies are designed to modify the underlying neuronal pathways which underlie the patterns of how we react. First, in a safe environment, we recall the felt sense of how we freeze or run/ Slowly, we connect the body feelings to the cognitive understanding. This slow, steady work is designed to modify the neuronal pathways underlying our perception and emotional reactions, and provide us with new patterns of emotions and behavior.
Neuroception: Below our awareness
Another important insight in trauma therapy is the biological concept of neuroception. Neuroception is a term developed by Stephen Porges, Ph.D. It means the autonomic nervous system is continually scanning the environment for threat at a level below conscious awareness. So, the brain first continuously receives incoming sensations from our sensory organs (sight, sound, touch, etc.). Then the brain perceives the experiences we are receiving on a subcortical level. Milliseconds later, the sensations and perceptions are passed on along for interpretation by the the upper brain, on a conscious level.
This means we are constantly reacting on an emotional and physical level before the sensations and perceptions reach the upper brain and become coherent thoughts.
If we perceive danger, cortisol is released into our bloodstream…and our heart rate goes up, even if it’s just a little. Our digestive system grumbles, our palms get warm.
And the thing is, we don’t have access to a wide choice of behaviors when we are perceiving a threat. The autonomic nervous system hijacks the upper brain and we go to survival patterns of behavior and emotion.
On a subcortical level, we are constantly determining whether situations are life threatening, dangerous or safe. Neuroception tells us whether or not someone’s smile feels fake or sincere to us. Is this person trustworthy? Do we like him or her? We send out our feelers via neuroception.
Is this neuroception always accurate?
Since we formulate our responses to perceived threats based on existing neuronal pathways, which were shaped by our individual experiences, we interpret situations in light of our past experiences. Due to past experiences, some of us might have hyper-sensitive distrust and fear reactions. Repetitive over-reactions over-stimulate the autonomic nervous system and the endocrine system, which precipitates chronic anxiety, depression, fear, hyper-vigilance, etc.
Since much of this interpretation goes on at an unconscious level and is maintained by physical neuronal pathways, it is resistant to change. We can know we have an unconscious bias towards distrust and fear, but might be be unable to change this feeling via talk therapy. Actual physical changes in the brain and nervous system must occur. These brain and nervous system changes need to precede or be in parallel with, a change in psychological and emotional symptoms.
Luckily, we have the inherent capacity to change because of our bodies’ capacity for neuroplasticity and our inherent psychological determination to survive!
In 2020, our treatment methods have evolved as as our understanding of holistic impact of past experiences and trauma on the human body has evolved.
As stated above, our individual neurobiological platform is shaped over time. We develop ingrained habitual responses based on our experiences, which directly shape our neuronal programming. As we go through our daily lives, we draw on our neural platform for a host of emotion, responses and behaviors.
Impacting neurobiology is done through somatic and experiential therapies such as Somatic Experiencing®, EMDR and movement therapies.
Current trauma treatment is done in a safe container. We develop the observer self, slowly experience and notice the fearful somatic and emotional responses, and slowly integrate the emotional and rational self. This modifies the physical neurobiology of the fear and immobilization.
In addition, learning new emotional skills to have alternate emotions and behaviors to draw upon also help. Dialectical Behavior Skills (DBT) skills are safe, effective and intelligent skills for people who grew up without good emotional role models.
Clancy, Deuchars, & Deuchars, 2013. The wonders of the wanderer. Experimental Physiology, Jan, 98(1) p. 38-45. https://rdcu.be/bZf00
Dana, D. (2018). The polyvagal theory in therapy. New York: W.W. Norton & Conpany.
Kain, K. and Terrell (2018). Nurturing resilience. Berkeley, California: North Atlantic Books
Hannaford, C. (1995), Smart Moves: Why learning is not all in your head. Salt Lake City, Utah: Great River Books
Levine, P.A. (2015). Trauma and memory: Brain and body in a search for the living past. Berkeley, California: North Atlantic Books.
Rosenberg, S. (2017). Accessing the healing power of the vagus nerve. Berkeley, California: North Atlantic Books
Van Der Kolk, B. (2014). The body keeps the score. Penguin Books: New York.