Part of a technical explanation as to why it's difficult to heal from PTSD

From a physiological perspective, "profound alterations in stress hormone secretion and memory processing" are found in people suffering from PTSD. Due to "ascending amine projections," soldiers with PTSD showed the physical symptoms of "flexor changes in posture, hyperkinesis, violently propulsive gait, tremor at rest, masklike faces, cogwheel rigidity, gastric distress, urinary incontinence, mutism, and a violent startle reflex" (Van der Kolk, 1987).

Kolb first proposed that "excessive stimulation of the CNS at the time of the trauma may result in permanent neuronal changes that have a negative effect on learning, habituation, and stimulus discrimination" (Van der Kolk, 1987). Dr. Bessel van der Kolk explains that traumatic memories are stored at the "implicit" memory level which changes a person's "biological stress response" to those memories (Van der Kolk, 1987).

Because these memories are processed outside of the "hippocampally mediated memory system," they are difficult to "extinguish" (Van der Kolk, 1987). Implicit memories also are different from normal memories, called narrative, semantic, or declarative, in that they are not stored verbally.

Because they are so physiologically overwhelming, they bypass verbal encoding and processing and are stored in the more primitive, "somatosensory or iconic," part of the brain as sensations, images, and feelings. These memories are stored as "emotional responses, skills and habits, and sensorimotor sensations related to experience" (Van der Kolk, 1987).

"Speechless terror" can be used to describe a traumatic event in which the "emotional impact...interfere[d] with the capacity to capture the experience in words or symbols" (Van der Kolk, 1987). Conversely, declarative memories are formed by attaching to "existing mental schemata: once an event or a particular bit of information is integrated into existing mental schemes, it will no longer be accessible as a separate, immutable entity," contrasted with traumatic memories that dissociate and remain separate from the central ego (Van der Kolk, 1987).

The two types of memory stimulate different parts of the brain, as observed on a PET scan. When implicit memory is recalled, instead of being evaluated rationally, the memories are more likely to stimulate a fight or flight reaction. People with PTSD have trouble over-riding their physical responses to memory-triggering stimuli because they have no verbal connection to the memories with which to mediate (Adams, 1998).

_Sky,

I haven't been able to read this. I start but my brain is overloaded at the moment so it's like oil on water.

But on a quick sweep, are you saying that PTSD changes the chemicals in the brain? My P-doc has been telling me this for years.

I have had PTSD since early childhood. Now that I know what I know, I can look back and see it clearly.

Wonder what my brain would've been like without any changes, lol.

Is that what this article is about?

I'll give it a better read after the holidays.

Exactly Petunia. This text (and there's more where it came from) is showing that PTSD is NOT a psychological (only?) disorder...but a medical one.

When the trauma occurs, it causes changes and over time more changes that can seemingly become permanent (though not) but the physical reactions are not caused by our psychological makeup only... (such as the flashbacks etc) but because of the chemical changes the trauma caused.

I'm working on learning about this too...and have been for years also...(SO I might not be relating it exactly, which is why I posted the info.)

My T remains consistent and is probably pleased I'm finally beginning to "get it."

Thanks for posting this, Sky. I've been struggling with the whole concept of PTSD being a permanent physiological change. My Pdoc and I were discussing ptsd yesterday and how profoundly physical my trigger reactions are. It helps to be able to explain to people (who think that I am just mental) that ptsd is physical damage to to the brain.

I have been in a place where I have not been able to react to this until now. As much as my mind allows, I get it. I wish that there were easier answers to rewiring ouir chemistry. Wishfull thinking to be sure huh? It explains a lot about my body and my pain that is not seen on a MRI. BONE PAIN for one. I don't know what to say except I hope we can understand more and more so it gets better.

Hi Sky, I have worked with this information for may years as well. I too had to come to grips with the idea that there was damaged that had occurred to the brain during my trauma. But I only started to heal when I approached the damage as if it were not permanent. Like a stroke victim that has to work long and hard to recover, say, their speech. As a trauma patient I too have to do long hours of, in this case, psychotherapy to recover the pathways that were harmed by the trauma. My therapy helps me recover memory or appropriate response to touch in relationships and response to sounds - many different things that were altered during the trauma. The map is being corrected so to speak. I’m sure all the data isn’t in on whether you can ever recover everything but I think we can use other medical models as examples as to our potential progress at least that is my hope because that is where there is the greatest hope IMO.

That is interesting Marian, thank you for your post.

I have also spoken with someone who is expert in PTSD and it was shared that you can't really begin to heal from PTSD until you realize you can't be cured... it's a paradox I don't have the right words to describe right now

I'll try to do better on it in the future.

Part of my problem is also that my PTSD comes from an industrial accident that also caused mimimal brain damage? Head trauma anyway. I have no idea what is fixable and what isn't.

BUT I went searching on the physical aspects of PTSD after my ignorant attorney, the opposing attorney and my MD all three had a deposition about MY FUTURE treatment and needs AND NOT ONE OF THEM EVEN MENTIONED PTSD in the depo!!!!!!!!!!!!!!

Hi Sky,
First and foremost let me say how sorry I am that you are going through such anguish. At a time when you should be putting all your strength and resources’ into taking care of yourself the people that are suppose to represent you have put you in a position of additional stress instead of relieving you! It is just unethical These law/insurance systems play hell on those of us who are hurt!!!
I hope you can insist that they include some future treatment plan for PTSD because although it maybe a lifelong ventures it can and does improve! The paradox you describe I have experienced too. What immediately came to mind is an image of my going to work via the same street - my normal route to work (my normal brain function) something happens and the street is no longer accessible (trauma) if I stay in the mindset that PTSD is not fixable my mind continues every day to try to take that same route to work, on that same street and each day I am deterred. I never make it to work, every day I am blocked. But if someone puts up a street sign telling me that road is out (therapy) eventually my mind will try to find a new way around. My brain will try to remap a new route to work. Now maybe the normal path will remain damaged but the new path accomplishes the same goal! I have managed to retrain the brain. That is what I think the paradox is – the damage remains but a new course is plotted. Not very scientific but simple enough so that you can see that PTSD can be corrected and a way so that you might be able to convince your representatives that they NEED to work some future treatment into your plan. Sophisticated no, but it removes the obstacle that “we can’t treat something that can’t improve”.

My intention here is to help if this isn't of any help please ignore it. Frankly you have too much on you plate right now for anyone to clutter it.. so take it with the intent with which it is offered and I hope you are able to convince them that you NEED future PTSD Treatment. Good Luck

Best - Marian

Thanks Marian1. Yes, my clinical psychologist is expert in pain and stress management, and they DO pay him...for sessions 3x a week and emergencies too (though not all of them of course, like the 3 am ones )

BUT that the 3 of them left it out of the deposition is ridiculous! They are IDIOTS! I tell you! But then, few ppl can be as intelligent as my T and me Can you tell I'm having a good day today? (AND I'm gonna milk it for all it's worth!)

Thanks for posting that, Sky. That makes so much sense. I have been fighting the diagnosis of mental illness for a long time but that helps me to understand what I am going though is very real.

What journal/book did you find Van der Kolk's info in? Did you find any tips on reducing the effects of the condition? I am still triggered often when watching TV especially when people talk about survival.

There are several different quotes there...

Van der Kolk, 1987 Psychological Trauma, American Psychiatric Press, Wash. DC

Le Doux talks about this too:

http://www.cns.nyu.edu/ledoux/overview.htm

In particular:

> Research into the brain mechanisms of fear help us understand why these emotional conditions [phobias and traumas] are so hard to control. Neuroanatomists have shown that the pathways that connect the emotional processing system of fear, the amygdala, with the thinking brain, the neocortex, are not symmetrical -the connections from the cortex to the amygdala are considerably weaker than those from the amygdala to the cortex. This may explain why, once an emotion is aroused, it is so hard for us to turn it off at will. The asymmetry of these connections may also help us understand why psychotherapy is often such a difficult and prolonged process- it relies on imperfect channels of communication between brain systems involved in cognition and emotion.

These low level basic emotional responses do become automatic due to experience. We can learn to have some control over their expression, however, though it is hard work...

I think that mindfullness helps...

"speechless terror" describes the reaction to many of my childhood traumas. It's so strange to see the words "speechless terror" - just the words alone bring me back to specific events.

I'm glad to finally have a name for my feeling.

One of the T I worked with told me that I had unspeakable trauma before my brain develped the capacity to process it. I could only feel it, not process it.
Don't know if anyone understands what I'm trying to say.

Damage was done very early in my life and so it made it even easier to cause further damage as I continued to develop.

I once went a year without speaking - anyone else have an experience like that? My parents didn't think that was strange huh???? My mom just pleaded with me to talk so that the teachers would stop calling her.

Yes of course we understand that. My PTSD is due to a disabling injury 20 years ago... but trauma before age 3 is also quite devastating when you don't have words to put to it. (((hugs)))

My main emphasis here is that PTSD is a MEDICAL condition...NOT "just" a psychological one. When many professionals (such as in my life MD, Lawyers) don't realize that it isn't "all in one's head" but has a physical component causing the distress, it makes it that much harder to heal also, imo.

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any psychological condition has to be realised on the brain because psychological processes are realised on the brain.

there simply aren't any psychological processes that are not realised on the brain.

implicit memories (experiences) are not encoded in linguistic (explicit) form. it isnt' just traumatic memories that happen that way it is a feature of memory in general.

e.g., a child knows how to catch a ball but can a child tell you the trajectory of physical objects at a momentum? i know how to catch a ball but does that mean that i know the trajectory of physical objects at a momentum?

behaviourist research has shown that memory can be implicit (non verbal). the majority of our experiences are like that. in particular the experiences that were formed before we developed linguistic competence (i.e. when we were three) but also a whole heap of adult experiences.

that puts a considerable responsibility on the therapist with respect to our verbally 'remembering' things that were not encoded in linguistic form...

but the feelings (in the present) are of course very real.

no matter how veridical our explicit memories

the feelings (in the present) are of course very real.

i've been reading about fear of disintegration (a little). the horror. the horror...