Few things push my figurative button more than someone telling me, or one of my clients, to “just get over” the trauma we have experienced in our lives.  Some people cannot understand why those of us who have lived through prolonged periods of trauma cannot just shake it off and move on. They seem determined to judge us as deficient for not being able to do so. We are malingerers, lazy or manipulative. We want attention or enjoy the victim role. They cannot grasp how it is that we still suffer from the aftereffects of our traumatic past.

There are so many reasons why. Explaining all of the ways trauma disrupts and destroys lives is a whole blog series in and of itself. The most effective information I’ve ever shared with those who doubt the negative and long lasting impact of trauma is how that experience permanently changes the way the brain functions.

When we encounter a life threatening situation our body reacts by pouring chemicals into our blood stream. These chemicals, such as adrenalin, are steroids. They increase our capacity to succeed with the fight or flight necessary to preserve our life. They increase our strength, allow us to mentally focus on the situation to the exclusion of other environmental stimuli, increase our pain tolerance, and give us the emotional stamina to endure horrible conditions without “falling apart”.

These chemicals are extremely helpful in situations when our survival is at risk. But our bodies are not meant to be flooded with them long term. To the contrary, in large amounts over long periods of time they are toxic to our bodies.

Prolonged exposure to life threatening situations, such as abuse or involvement in a war, keep our brain bathed in a constant flow of steroids. As a result of chronic exposure to these chemicals the way we processes information is permanently altered. The alteration is so significant that it can be difficult to tell the brain of someone with a traumatic brain injury from someone who has undergone prolonged trauma. This is significant! It tells us that trauma causes brain damage. Permanent brain damage.

Our brain structure changes in three ways: some areas get enlarged, some structures shrink and some processes deteriorate. Our amygdala, which plays a critical role in emotional regulation and processing, becomes larger. As it grows in size it increases the control it has over the rest of the brain. Emotions, rather than logic or reason, gain greater and greater ground in determining our actions.

The hippocampus, which facilitates learning and memory, and the prefrontal cortex involved with cognitive processing, become both smaller and less effective. Prolonged exposure to the chemicals trauma calls forth forever destroys the neural capacity of these two brain structures. We lose our ability to reason and process new information logically.

A third element of brain functioning that is damaged is the capacity to process those chemicals that prevent or cause depression and anxiety. Our neurotransmitters lose the ability to absorb, produce and re-uptake substances such as norepinephrine and serotonin. Without the capacity to optimize the balance of those chemicals we develop mood and anxiety disorders. Medications can help an individual correct some of these imbalances. But it is not a cure. In fact, nothing can cure or reverse any of these changes. They are permanent.

Think for a moment about how those two brain structure changes combine to effect an individual. They are vulnerable to severe, prolonged depression and anxiety. They lose abilities to reason and are, instead, ruled by their emotions. That is a powerfully negative change in brain function.

To help understand the impact of these changes let’s walk through a life experience and examine how those without a background of trauma respond versus those who have experienced trauma will respond. For this purpose let’s consider an individual whose car breaks down on the freeway. This is a stressful situation for anyone, but for trauma survivors it explodes into an experience that feels like their very life is at stake.

A non-trauma survivor would feel stressed, but would likely focus on getting their car off the freeway and to a place where it can be repaired. They would feel anxious and upset but those emotions would not rule the way the decisions they make in the moment. After they and the car are dealt with then they feel and deal with their emotions. But even then their reaction would be reasonable and understandable.

A trauma survivor though would be overwhelmed by their emotions the second the car stops functioning. Their emotions will rule their behavior and thought process, to the point that they may be incapable of handling the necessary process of removing their vehicle and themselves from the unsafe situation. It may take the intervention of another person to resolve their emotional reaction and deal with the removal of the car from the freeway. They will, as some of us may describe, overreact. Their response will be extreme to those observing or hearing about the situation

Those are two very different reactions to a scenario which most of us will experience at some time in our lives. But the way a trauma survivor responds has nothing to do with weak character, being “too sensitive” or any other personal flaw. It’s the way their brain functions. Period.

Can the brain damage be reversed? No. With professional help can a trauma survivor learn ways to cope better with the damage? Yes. But there is no quick fix. It takes a prolonged period of rehabilitation, something our mental health system doesn’t like to provide.

So let’s abandon the “just get over it” way we judge trauma survivors. Instead, let’s provide them with compassion and understanding. And most of all, let’s get them the help they need to cope with life after brain damage. They deserve the best possible chance to live a happy, productive life. Let’s leave the judgment behind and, in its place, offer hope and healing to people who have already suffered so much.

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