Symptoms of trauma are too often misinterpreted as resistance or lack of interest in treatment. This article provides information on trauma's effects on the brain in layman’s terms—which is usually more helpful with clients than professional jargon.
When we feel threatened, our “survival brain” takes over—that’s what it’s supposed to do. If we waited for our “intellectual brain” to analyze some situations, we’d be dead. For example, our survival brain helps us jump out of the way of an oncoming car before our intellectual brain can compute the best course of action based on the vehicle's speed. The survival brain makes sure we get out of the immediate danger through a “fight, flight, or freeze” response.
Survivors of trauma have brains that are filled with information that includes many cues tied to the traumatic event. The survival brain does a good job of storing the information needed to protect these individuals again in a similar situation.
Clients often remain in survival mode after the danger has passed, but the exact same behaviors that protect them in a crisis might become obstacles in daily living. Others might interpret the working of the survival brain as dishonesty, suspicion, anger, stubbornness, and a host of other negative attributes.
Because of this, some clients begin to see themselves through others’ eyes, and come to believe that they are no longer nice people. Rather than recognizing and valuing the efforts of their survival brain, they come to view it as a “bad” part of themselves. Substance abuse treatment too often supports this perspective.
Much of the torment that trauma survivors suffer comes from an internal conflict between what they believe is the “good” and “bad” them. They may judge themselves harshly because they don’t understand why they do what they do.
Many dually diagnosed clients’ brains are still in survival mode, maintaining the behaviors that saved their life or made life bearable, even after the immediate threat has passed. This surely does not make them bad people.
How to intervene
You can help by raising your clients’ awareness of the survival brain and intellectual brain, as two very helpful sides of themselves. We should never try to undermine our survival instincts, because we will almost certainly need them again. What we can do instead is to help our survival and intellectual brains make friends with each other.
Clients benefit from recognizing the importance—and goodness—of both the survival and intellectual brains. This keeps them from being at war with themselves and helps restore balance in their lives. If necessary, educate trauma survivors on the contributions of each of their good sides.
Good side #1, our survival brain, is truly amazing. It makes goal-directed action possible without any conscious thought. It helps us duck out of the way of a falling object before our intellectual brain even knows it is coming. Our survival brain includes our instincts for survival and self-preservation. Nobody has to teach us to be hungry, sleepy or sexual. We can thank our survival brain for all the good stuff that nobody ever had to teach us.
Good side #2 is our intellectual brain, with an equally important job. It can help clients observe and regulate the behaviors they are trying to change. It is logical and problem-solving. It gives us values and our ideas on right and wrong. Language, and all the other good stuff that we’ve learned, would not be possible without our intellectual brain.
Help clients value all of these internal resources. When their survival brain responds to cues tied to the trauma, don’t misinterpret the anger or other coping skill as resistance or lack of interest in treatment.
“Amygdala hijacking” is an unfortunate term some professionals are using to describe the survival brain’s response to certain cues. This term could lead clients to believe that they have a defective brain, even though they have a perfectly good brain. The term also reinforces the unhelpful idea that clients are at war with a part of themselves.
Clients often are relieved to know that the survival brain and intellectual brain can be friends. Viewing the relationship as a partnership, rather than a competition, may help conflicted clients feel whole, and help them heal. Both brains need to do their share of the work.
Our survival brain releases chemicals that initiate the fight, flight, or freeze response. When our intellectual brain is goofing off and letting our survival brain carry too much of the load, too much of these chemicals may cause problems, including memory loss, fatigue and depression. Laughter, exercise and other activities release hormones (endorphins) that help our mood and bring down the level of these chemicals.
So our intellectual brain can plan activities that encourage the survival brain to release helpful hormones rather than harmful chemicals. The intellectual brain also can help by sorting out the traumatic cues that no longer are signs of imminent danger.
Because of the way our brain works, the more a behavior is repeated the more likely it will be repeated. Our survival brain doesn’t seem to know the difference between a helpful and an unhelpful pattern of behavior, but the intellectual brain can weaken the unhelpful patterns by consciously building newer, more helpful ones.
Nicholas A. Roes, PhD, author of Solutions for the 'Treatment-Resistant' Addicted Client (Haworth Press) is Executive Director of the New Hope Manor residential treatment facility in upstate New York. Click here for more information.