How do the frontal lobe and limbic system affect trauma? Can we “unstick” the brain from painful memories without patronizing or justifying? Victoria Gutbrod, LPCC-S from Renew Counseling Ministries here in Fairlawn, Ohio, and Nick Angelis, CRNA discuss the latest research about our complex nervous systems. The brain can be reborn, and the spiritual imagery asks all manner of thought-provoking questions about God, Xanax, and the role of psychiatric and psychedelic care. We can reshape neurons on a molecular level inside brain’s frontal lobe, but none of that matters unless behavior changes. Ketamine clinics often talk about the release of brain-derived neurotropic hormone, but again, all these positive changes must be recognizable to change the decisions we make and the life we live. After all, cocaine also releases BDNH, and marijuana, alcohol, and meth all release chemicals that temporarily enhance well-being. Much like a Jenga tower, one wrong move and self collapses. Soul health requires such brutal honesty as we shred false comforts and begin the hard work of healing from PTSD. Transcript below.
Nick:
Hello and welcome to the Ascend Health Show. I’m your host, Nick Angeles. I’m one of the owners and I’m a nurse anesthetist of Ascend Health Center. And I’m here with Victoria Gutbrod, who is an lpcs at Renew Counseling Ministries. Yeah, one of.
Victoria:
The founding partners. That’s right. There’s four of us there.
Nick:
And how are you doing today? It’s a little bit of a rainy day, but I’m.
Victoria:
Doing all right. Oh, great. It’s a little bit of a rainy transition today, that’s for sure. We’ve had some beautiful weather, but it’s definitely rainy and cloudy out there.
Nick:
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 wanted 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?
Victoria:
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.
Nick:
Okay. So is it almost that they can keep it all together until something happens unexpected?
Victoria:
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 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 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 in 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 reentering a family system. And so you’re having to draw upon those memories and 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?
Nick:
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.
Victoria:
Yeah, that’s one of the ways that family systems and even other meaningful individuals will harm others or revictimize them is when they will 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 to sure. So I tend to see layers.
Nick:
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, Oh, this sounds like something you need to see a therapist about.
Victoria:
Although that’s not a bad thing to say. But there you go.
Nick:
So be aware that what’s a small way that. We can help because in some ways in our culture we almost say, Well, why don’t you go see the experts? I can’t help you. But that itself is minimizing like, I don’t want to deal with this.
Victoria:
Yeah, that’s exactly right. I like the way you reframed that. Really just validating. You mean like, that’s so hard? I didn’t know that. Thanks for sharing that with me. That’s so vulnerable. I can see how it’s impacted you. I can see the 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? And sometimes just being able to we use the language like witness bear witness, 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.
Nick:
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.
Victoria:
Yeah, absolutely. Absolutely. I think it’s so important. Even as therapist, 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 what I would call myself, is we cannot escape this life without some form of trauma, right? Not all of us develop PTSD. But what what does cause PTSD? PTSD is when something is almost frozen in stored, neuromuscular in the system. So 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 in front of us at that time.
Nick:
So 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?
Victoria:
Yeah, that’s a really great analogy. 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, all 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 or it will have learned from something. So it knows two plus two equals four and it will always recognize that. And so but when it becomes as 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 reenter into that state. And 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, Right. 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 brainstem. Right. So it’s very primal. It’s very survival istic.
Nick:
That makes sense. Like obviously at 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. 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 Ketamine infusion, which can be intense and they’re like, 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 Jenga 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, you 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.
Victoria:
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 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. 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 bilateral by bilateral and cross lateral communication between these quadrants of the brain.
Nick:
It makes sense because you’re almost saying, you know, let’s go back to caveman and if you’re trying to stab a mammoth so you can have food for the winter, you don’t have jokes, you’re concentrating 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.
Victoria:
That’s it. 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 and got to see vessel 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 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 questioned 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 are some personality disorders that really go are a byproduct of trauma and they’re really the brain’s response to trauma. And you will see that they show up only under social. Racial 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. They don’t have the empathy. You see that 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. They almost feel like apologies or owning their stuff is is too vulnerable. Right? 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 that 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 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.
Nick:
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. Of, 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 Jenga example because 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, they really just have to get their act together and start stop causing all this drama. Yeah, okay. Just grow up, right?
Nick:
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 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? 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 the 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 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.
Victoria:
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 the big picture. So it’s not just depression. It’s not just anxiety. It’s not just mood disorder. It’s not just, you know, what what we’ve labeled or defined. I mean, we have to do that so that insurance pays us right. We have to be able to have this diagnosis. Right. 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 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 to its full capacity, the healing happens. And so, you know, for me it’s always about the system becoming whole. It’s always about that. And it’s not that the system becomes perfect. There’s no such thing as perfection. It’s just wholeness. And wholeness is about being able to utilize, you know, mind body spirit in its presence and in its fullness in the now.
Nick:
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.
Victoria:
Yeah. It’s so fascinating because I was in a car accident and 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. As someone who had an anxiety disorder most of her life 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 my limbic system did exactly what it needed to do. I didn’t have to have a conversation with it. It just took over. It really did. And what I 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. 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.
Nick:
Right. As it should.
Victoria:
And what’s fascinating in is our culture and what I was able to do in the months after the accident 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 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, right? And then my brain was able to remember the millions of times I’ve driven and been safe and it just went, oh, like, right. But when we stay trapped in that mechanism is when we start to develop again and we stay, we we develop that more PTSD response because basically we’re staying frozen or trapped or.
Nick:
We’re almost walling off that, right?
Victoria:
Yes, we’re walling it off. We’re closing down the roads. We’re closing down.
Nick:
The saying is instead of having a civil war in our bodies, like how can this depression 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 instead? No, 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.
Victoria:
That’s exactly right.
Nick:
And being gentle 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 and more adaptive. More. Can’t wait until I get better. It’s like, okay, I’m. Improving every day. And sometimes my anxiety is still thinks that it needs to be in charge more than it does. But I’m still grateful for when I do need it.
Victoria:
Yeah. The anxiety or depression takes over because it really is trying to protect you. 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 and conjunction and harmony and I think our bodies, when we start to listen to them, recognize, you know, what it is that they need. And sometimes as we get well, we need less medication or we can go seasons with, you know, other ways that we’re we’re supplementing and complementing them. And so that’s why I love Ketamine and that’s why I love working with TMS because they are an alternative to just, 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.
Nick:
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 than this is one thing that can help me.
Victoria:
Absolutely. And as an individual who has a strong faith background, you know, renew, you know, we are founded by four of us. There are 17 therapists there now. And, you know, we have a strong faith component. You know, we do believe in 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 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.
Nick:
Because we get to ask, Well, thank you Jesus, for your guidance. We’ll let the tools will help me as I try to grow closer to you. It’s something I’ve told many 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?
Victoria:
Yeah, that’s true. I always say if anyone understands trauma, it’s Jesus.
Nick:
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?
Victoria:
Our website is renewcm.com for counseling for ministries, renewcm.com. They’ll have all the information on there, ways to contact us and reach out and and seek any support from any of our therapists that are seeing clients at this time.
Nick:
And the same for us. It’s a ascend health Center.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 strange 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 weel with each other.
Victoria:
Absolutely.
Nick:
Well, thanks for joining us today. Thank you.