Trauma & the Brain

hello and welcome to the Ascend Health show I’m your host Nick Angelis I’m one of the owners and I’m a nurse anesthetist of AscendHealth Center and I’m here with Victoria got broad who is an LPCC-S at Renew Counseling Ministries

yeah one of the founding Partners there’s four of us there and how are you doing today it’s a little bit of a rainy day but we’re doing all right it’s a little bit of a rainy transition today that’s for sure we’ve had some beautiful weather but definitely rainy and cloudy out there it’s a great gloomy day to talk about mental health that’s for sure

so I’ve been trying to get you on the show for a while just to pick your brain and learn at your expense but I want to talk a little bit about trauma in the brain and we’ve also been discussing a lot about the frontal lobe which is somewhat new information to me on how it develops and the fact that often trauma stunts our growth

many times we think of it almost of an emotional stagnation where we end up stuck in a certain spot in our lives and we can’t really grow from there so can you tell us a little bit about that

well yeah I often see when I’m working with clients who have trauma complex trauma PTSD whether it’s been something that has been a single episode incident and then there’s more like the pervasive ongoing complexity of childhood trauma that has a longer span I will often see that certain parts of the personality certain parts of the social and emotional functioning are stunted so for example you will see that someone will grow chronologically they will grow developmentally even intellectually they’ll have capacity to function but you will find that when it comes to emotional and social stressors they will regress or they will be stagnant in the way that they can tolerate or manage those difficult life circumstances okay so is it almost that they can keep it all together there until something happens unexpected um that’s one of the triggers it’s really how the brain perceives pressure you know the brain stores trauma through our senses so it depends upon like what activates someone and what um what will bring that memory to the surface you know I often explain to individuals I talk to them about how their brain is almost like hoarding trauma hoarding Terror hoarding things that are stressful and so what happens it hasn’t fully been processed into long-term memory and so it’s kind of hanging out there and the brain doesn’t have the capacity to really um in in think beyond the threat response because it’s constantly using all that information it’s stored in short-term memory to think about what could be threatening at any given moment and so it’s using its senses to do that so it can be just a voice it can be a sound it can be a time of year it can be a relationship I have a lot of clients who will return to counseling when their children are at the age that they were impacted with a specific childhood trauma or wound sometimes it’s just the act of becoming a parent and sometimes it’s even marriage can activate someone because you’re you’re re-entering a family system and so you’re having to draw upon those memories on those experiences so I really it’s so hard to say not one person is there’s there’s no way to define what will activate someone until you understand their story right so it’s minimizing and invalidating if you’re if you say oh well that wasn’t that big of a deal or that shouldn’t have affected you that way or you should be over this by now yeah that’s one of the ways that family systems and even um other meaningful individuals will harm others or re-victimize them is when they will um when they will minimize or kind of distance themselves from or dismiss a lot of times the emotional experience that that person has had because it was important to them or that part of them or in that season of their life it impacted them and there tends to be like layers too sure so I tend to see layers so if we have a family member or a friend that we feel is going through something like this what is the right approach because it’s probably not this sounds like something you need to see a therapist about although that’s not a bad thing to say

so I’ll reword that what’s a small way that we can help because you’re in some ways in our culture we almost say we’ll want you to go see the experts I can’t help you but that itself is minimizing like I don’t want to deal with this yeah that’s exactly right I like the way you reframed that really just validating you being like that’s so hard I I didn’t know that thanks for sharing that out with me that’s so vulnerable I can see how it’s impacted you I can see the in I can see how it’s still replaying in your head that’s got to be challenging for you is there anyone you are open to talking to have you been to counseling you know what is it that you need from me um and sometimes just being able to we use the language like witness bear witness um you know be a source of validation for them validation isn’t like hey I agree with everything you said validation is like wow I’m seeing you and hearing what you’re saying and that’s really I can see the impact it has had on you so you’re saying that that way we take ourselves out of the role of Judge that instead of ever saying like you know that wasn’t really a big deal and you’ve mentioned it several times you can just say I can see that this is still affecting you yeah absolutely absolutely I think it’s so important even as therapists we talk a great deal about that because we see such a spectrum such a wide range of how individuals are impacted and you know we used to look at trauma through a really narrow lens we used to think of like a single incident or we used to think of like horrific experiences but really honestly from the perspective of a attachment and Trauma theorist which is is what I would call myself is we cannot escape this life without some form of trauma not all of us develop PTSD but what what does cause PTSD patsd is when something is almost Frozen stored um neural muscularly in the system so it’s it hasn’t really been eliminated or discharged or reset in our nervous system so it stays like trapped inside of it and whenever socially or emotionally we are activated with that then it will resurface that physiological learned pattern of how we protected ourselves in whatever circumstances was ahead of us or be in front of us at that time s

o you’re saying that often a person may seem completely stable but it’s almost like a Jenga Tower where if you do suddenly add a stressor to the situation it’ll all collapse yeah that’s really great um a g it’s like a Jenga Tower and it can probably have certain pieces removed without it collapsing but when a very key component is removed the system can easily collapse and that’s why it’s so important to recognize the impact that that has had on the individual versus just doing a generalized like hey old old trauma impacts people this way because not every not every individual that goes through traumatic experiences end up with PTSD they can still get activated by it but it’s a different way that the brain will perceive it it will almost kind of go back into its memory circuits and say oh yeah that happened it was really bad it will have connection to it and it will have gained wisdom and understanding and it’ll say this type of individual is unsafe you know I need to protect myself from that um or it will have learned from something so it knows two plus two equals four and it will always recognize that um and so but when it becomes a trauma disorder when it develops onto the spectrum is when literally physiologically emotionally socially they are in a regressed state and they don’t really have presence of mind and they kind of lose the space and lose the room and re-enter into that state um so there’s all kinds of amazing science now for us to go back and recognize the brain really isn’t firing in all four quadrants um you know the way it should it’s really kind of hanging out somewhere in the lower quadrants of the brain which would be more like the left the left feeling part of the brain and the right feeling part of the brain which is connected to the limbic system and the core brain stem right so it’s very primal it’s very survivalistic

no that makes sense like obviously a Ascend for those of you who it’s your first time watching this show we do ketamine infusions which is created to separate the limbic system from the rest of the brain and so it allows trauma to be processed and it allows people to go through things and it’s not at all a cure-all in fact for a lot of patients I say well you know what at the very least this will be Diagnostic and this will by the way that you respond to this this will tell us what’s going on and what the right path is forward whether it is just working on your neurotransmitters and trying to heal the nervous system or if this is something that needs to be completely done with therapy in many cases patients come to me with pain and they start a ketamine infusion which can be intense and they’re like I this is too high of a dose I can’t deal with this and I’ll tell them like well we’re not actually going to deal with your pain we’re actually just going to deal with the anxiety with the depression with the trauma and then the pain much like that jungle Tower will collapse on its own because a lot of times when you’re trying to Force the brain to do something which is the medical system take this pill change this neurotransmitter we’re going to make your brain do this and act the way we want it to work it may work for a little bit but it’s still a Jenga Tower you’re still covering up symptoms you’re still one block away from everything collapsing that’s that’s such a great analogy

I love that yeah I’ve had several clients we’ve referred to the ketamine and also the TMS that you do and it’s been fascinating for me to watch their brain expand because what we do in a lot of the treatments whether it’s somatic whether EMDR whether we do you know other interventions we are trying to get them to move past the limbic system into the higher regions of the brain the thinking part of the left brain the thinking part of the right brain and then the communication and the engagement of the frontal lobe so you will also find you know a lot of individuals with trauma have underdeveloped I would say personalities under stress and so they don’t have access to the higher regions of their brain they don’t have the ability to be in that like mature part of that brain that cognitive part of the brain um and so what’s fascinating is you will see their personalities mature and evolve and grow and their ability to have what I what we would say like by lit by bilateral and cross-lateral communication between these quadrants of the brain um it makes sense because you’re almost saying you know let’s go back to cavemen and if you’re trying to stab a mammoth so you can have food for the winter you don’t have jokes you’re concentrated on Surviving and so if you’re in a survival mindset your personality whether it’s this expressive shining hilarious personality or just even a quieter one it doesn’t have time to express itself the brain’s like how about we put this personality aside and we worry about surviving and then you can talk about yourself or whatever else so what you’re saying is that the brain says no we cannot focus on anything enjoyable or fulfilling what we really need to work on is survival that’s it you you nailed it that you see individuals when they’re in that state they’ve lost the ability to be curious be creative be inquisitive be present and so everything is being every part of their system is about searching for the threat and what’s fascinating is you know I’ve been contemplating this recently in the work I’ve been practicing for 20 years and have and just developed an interest in trauma um and got to see Bessel long before when there was only 30 of us in the room you know when I was early on in my career and he was just beginning to make his way into the field and really start to speak publicly well he was in the field but start to speak publicly let me reframe that and I remember how he lit up my brain and being a naturally curious creature I was able to see what he was saying in the um population that I was working with at the time and what I started to recognize is how Frozen individuals personalities became and how they didn’t have access to mature and grow in their personalities and as I developed further into my career and in this stage of my career I question a lot the concept of personality disorders because I really do honestly think that we’ve done a poor job of even defining them and recognizing them again I think there’s some personality disorders that really go are a byproduct of trauma and they’re really the brain response to trauma and you will see that they show up on only under social and emotional stress or when the system is feeling threatened so they don’t have access to be able to respond from a wise mature fully online brain you know they don’t have the empathy you see that there’s the lack of empathy you see there’s the lack of self-awareness the impact that they are having on others you see that it’s almost like a fragility with their ability to be like ooh the way I’m talking isn’t okay I’m hurting that person apologies are okay you know they almost feel like apologies or owning their stuff is is too vulnerable the fear of Abandonment they don’t have access to consequential thinking they’re not thinking big term they don’t have the distress tolerance or even the focus um that you know the focus on what’s in front of them the relationship Focus so you will just see these skills not present and you will see that as individuals develop and manage and begin to have a healthier brain you will see that they will outgrow personality disordered responses and behaviors and so I just think that’s a fee that’s part of our field that’s just beginning to be looked at we focus so much on trauma but we haven’t really talked about the impact that trauma has on personality right and I think the way we’re talking about this is in a healthy way because a lot of times especially with personality disorders it becomes this almost judgmental that’s exactly right well you have to watch out for this person if they’re your patient you instead of the Jenga idea would be almost like it’s a sharp vase that you just have to be very nice to them and make sure they don’t cause any trouble but I think I’m going to keep the jungle example because there’s it’s wood it’s solid until you start playing with it so instead of this okay how do we get by unscathed and give this person some rudimentary help and then move on instead it’s like no there’s a lot of potential that’s locked in there so instead of saying oh this poor person who hasn’t developed we really need to pity them or instead of taking the opposite approach if they really just have to get their act together and start stop causing all this drama just grow up right so instead we can say look there is potential here let’s unlock it let’s get through this the way I often describe trauma is the the brain will hold on to something and it’s almost like you have a bookshelf and all the books are scattered on the floor and the brain doesn’t know what importance do I have to put to this book where does it fit in the scheme of what’s happened to my life um one patient I had his friend died when he was younger he could never quite get over it because he said if I forget this then it’s I’m minimizing what my friend meant to me but at the same time he was thinking of it every single day so we were able to work with therapy with a ketamine where okay let’s put all these memories back on the bookshelf and we’ll order them so it’s still honoring the memory of your friend but it’s no longer something that is obsessing you every day where you can’t move past it so like not saying okay this part of yourself we need to get rid of it we can’t have it because it’s pathological but instead okay humans are complex and there’s a lot of puzzle pieces but right now some of these puzzle pieces aren’t fitting so let’s just do a little work so that you can kind of find who you are and from that knowledge of who you are you can get a better example of okay here’s my next step forward absolutely absolutely and when I look at a client or a case or I’m coming alongside the next generation of therapists as they are beginning to look at their cases and explore that what that looks like we look at it in in the big picture so it’s not just depression it’s not just anxiety it’s not just you know mood disorder it’s not just um you know what what we’ve labeled or defined I mean we have to do that so is that insurance pays us like right we we have to be able to have this diagnosis but oftentimes I find that it’s so much more complex because there’s a combination of things happening I’ve never found that there’s not some type of combination of ways that that the brain is trying to survive and it hasn’t yet developed enough Pathways enough roads enough experiences outside the limbic system outside the lower regions of the brain we need those lower regions of the brain they’re they’re necessary and it’s necessary that we move from the bottom up but we have to be able to tolerate the distress of crossing the threshold threshold to get into the higher regions of the brain so that we can actually a strengthen them develop them and begin to gain wisdom from what input that part of us can have and so it’s just really fascinating to me how when we’re thinking our way through it and we’re utilizing the full system the way you know to its full capacity the healing happens and so you know for me it’s always about the system becoming whole right it’s always about that and it’s it’s not that the the system becomes perfect there’s no such thing as Perfection um it’s just wholeness and wholeness is about being able to utilize um you know Mind Body Spirit right in um its presence and in its fullness in the now so it’s almost like you’re if you have a better understanding of the risk or you can understand okay this is a stressful situation I need to use this lower part of my brain or actually I’m not being threatened I’m just having a conversation that’s important with someone I don’t have to get defensive I don’t have to react so that knowledge almost yeah it’s so fascinating because I was in a car accident I don’t know five years ago and I remember after the car accident I had this new relationship with anxiety I’ve always taught my clients that you will become friends with anxiety and they’re always like no way someone who’s had an anxiety disorder most of her life um and you know has been in recovery and always working on it I’ve become so endeared to that part of me because when I was in the car accident my limbic system did exactly what it needed to do I didn’t have to have a conversation with it right it just took over it really did and what I’ve recognized is when I’m aware that it’s misfiring I have the conversation with it like oh hey thanks for showing up this isn’t really I need to be alert yes I need to be in tune with what’s happening um but this isn’t life or death you know and I’m able to utilize the higher regions of my brain and my personality and all these other parts of me to be in the present so just that in itself means it’s not threatening now there could be something I need to be concerned about or be cautious about but really truly when you are in a life or death situation your your limbic system takes over right um as it should and what’s fascinating in is our culture and what I was able to do in the months after the accidents because I would have this similar freeze response I was struggling with having to drive through that intersection I had to continue to do all the techniques I I teach my clients I had to do the traumatic release exercise I had to do all of the resetting of my brain I had to even do some of the bilateral reprocessing of it so that my brain was like oh that happened it’s no longer happening it wasn’t like I was able to easily access it I had to do the things to say to my nervous system like hey you can let go of that you can discharge that like hey thanks for functioning the way you did but it’s no longer happening so I don’t need that to stay on alert and then my brain was able to remember the millions of times I’ve driven and been safe and it just went ah like right but when we stay trapped in that mechanism is when we start to develop again and we stay we we developed that more PTSD response because basically we’re staying Frozen or trapped or um we’re almost Walling off that yes we’re Walling it off we’re closing down the roads we’re close instead of having a Civil War in our bodies like how can this depression I I want the way that people do with cancer sometimes I’m going to fight this cancer I’m going to defeat it and I often tell patients especially in anesthesia that’s still part of your body if you’re having a civil war with part of who you are it’s going to be very challenging because you’re fighting against yourself so you’re saying instead of saying I hate this anxiety I’m going to be chill about everything you’re saying said nope we’re just going to teach the different parts of our bodies like thank you for your service this is where you’re useful we don’t really need you today and being gentle with yourself that way as you as you said you won’t reach Perfection but you’ll be happier along the journey I can’t wait until I get better it’s like okay I’m improving every day and sometimes my anxiety still thinks that it needs to be in charge more than it does but I’m so grateful for when I do need it yeah yeah it the anxiety or depression takes over because it really is trying to protect you and and I understand that there’s a biochemical component and there’s also a hereditary component in the sense that we kind of inherit these genes and so by no means am I dismissing that and by no means do I not think that medication and medical intervention at times is necessary and beneficial I don’t know where if I would even be here today without the assistance of the medical model so by no means do I dismiss that I think they work in collaboration in conjunction and Harmony and I think our bodies when we start to listen to them recognize um you know what it is that they need and sometimes when as we get well we need less medication or we can go Seasons with um you know other ways that were we’re supplementing and complementing that and so that’s why I love ketamine and that’s why I love you know working with TMS because they are an alternative to just um you know the medical model in a different way and I have witnessed many clients and individuals who have had life-changing experiences because they’re just able to access parts of their brain that they just couldn’t right when they would perceive a threat and it’s like you said the key is finding parts that will work in harmony where we can add something and then perhaps take it out at a later time as it’s no longer needed so it helps us especially with the traumatic experience that we’re talking about the type of patients we’re referring to a lot of times this prevents the fixation of like this is the only thing that will help me instead it’s like well here’s an additional tool we’ll use this for a while as it’s most useful and then we can set it aside and pick up something else and that’s a much more sustainable way to find treatment then this is the one thing that can help me absolutely absolutely and as an individual who has a strong faith um background you know at Renew um you know we are founded by four of us um there are 17 therapists there now and you know we have a strong faith component you know we do believe in um the integration of our Christian values and belief systems into it it doesn’t have to be minimizing or watering down science you know we believe in that and so even though not everyone I work with subscribes to the same Faith system I’d find that often faith is so important to the healing Journey because it’s not just the physical body it’s not just the personality it’s also the aspect of the soul and how how we interact with that in our healing journey is very important because we get to ask thank you Jesus for your guidance whether the tools will help me as I try to go closer to you it’s something I’ve told made of my patients where a lot of times they feel as if the heavens are closed there’s a verse I believe it’s in Nehemiah about the heavens are like brass where they feel they are out of touch with their creative side they’re out of touch with their spiritual side and like you said it is because of that same trauma response where they’re just living in the now in the emergency in the how can I keep myself safe so that spiritual component is so important for not just a survival mindset but how can you thrive how can you be okay with the journey to Wellness instead of just being impatient of when will this Affliction leave me so to speak yeah that’s true I always say if anyone understands trauma it’s Jesus absolutely well thanks for coming to visit me today and if anyone wants to contact you if anything of what we said resonates they can connect through the website or what’s the best way um we our website is uh renew CM C for counseling M for Ministries renewcm.com um they’ll have all the information on there um ways to contact us and reach out and seek any support from any of our therapists that are seeing clients at this time and the same for us it’s Ascend healthcenter.com we deal with a lot of chronic pain issues like I mentioned most of them are from trauma where the brain has stored it and the nervous system is altered through fibromyalgia or migraines or strain symptoms so we deal with all that as well and you can visit us and we’re both in Fairlawn just a few minutes away from each other and we collaborate well with each other absolutely well thanks for joining us today [Music]