Stress and trauma are inevitably encountered at some point in life. How we process stressful events, at the time and when later remembering these, can determine whether we are in control of our own life story. Or whether we are just characters at the whim of the narrative! Research into how the brain functions in people suffering PTSD can reveal insights on how we can write a more consistent and satisfying autobiography of our lives...
In my blogs I put forward ideas from Adventure Psychology to help people figure a way to thrive in uncertain times, and make sense of the crazy world. By adopting an Adventure Mindset (I'll gradually reveal how) you can approach the challenges of life with an adaptable resolve, and embrace the chaos knowing full well that it's a wild ride so you might as well enjoy it!
“There is increasing talk about ‘self-care’, ‘self-compassion’ with respect to managing mental health...If we can pin down where the self resides in the brain, and mechanisms involved in its operation, then we can target these areas and effectively train our selves to be in a better place. Much as we might go to the gym to strengthen different muscle groups and work on our core...an understanding of these mechanisms can be useful to avoid slipping into a tormenting cycle of relived experience. "
Rewriting the script
There was a sudden bang, a cloud of smoke and a sense of slewing out of control towards the central reservation.
WTF!? A white blur hoved into view – another vehicle out of nowhere cutting across the lanes in front.
Sometimes you just have a bad day. All the positive vibes in the world aren’t going to stop that happening. Unexpected events occur and challenge our resolve.
I was minding my own business, driving down to south Wales recently when the above incident occurred. For a brief moment of rearranged senses, I couldn’t fathom what just happened. The unexpected, as Cilla Black once intoned, can hit you right between the eyes.
I’ve been there before in different circumstances. Jumping into mid air, be it out of a plane, off a bridge, even falling from a rock climb. The brain cannot process the experience that it has not had before. We rely on consistency from one moment to the next to piece together a world that has continuity, and meaning.
In potentially traumatic events, such as a car accident, we are likely to have that momentary disruption as the shock of the new blindsides us. As I have previously written about in contexts such as skydiving, the higher processes in our brains go temporarily offline as the instinctive parts take over. We lose control for that brief period. But what happens next, and beyond, is key to adapt and learn from the experience. This can help us in future situations to cope and respond better, but also to ensure that we do not relive the moment ad infinitum into the future (when we least expect it). PTSD is an extreme version of this – perpetual re-occurrence of an incidence that can hamper quality of life and ability to get on with things day to day...
Last time I mentioned how learning to skydive is a good example of how one can become more adept at remaining cognitively online when plummeting out of a plane at 125mph. Otherwise, you are bound to shut down due to sensory overload! Just because this is likely to happen doesn’t mean it has to. And whilst you may not always be able to stay alert and situationally aware when the unforeseen occurs, you can strive to get back online as quickly as possible nonetheless.
We've all been stressed out by things that happen to us: the confrontation that occurred in the street not your fault, the domino effect of events that led to your being late for that important meeting despite ensuring you would get there on time, the shock bereavement. The list goes on. It’s unrealistic to think that you can control the variables in your life to such a degree (with positive thinking!!) that none of this will ever occur. But you can have a modicum of control over how you process situations that are less than ideal, stopping them grow into elephantine proportions, trampling over your every thought in the middle of the night!
It starts with the self.
There is increasing talk about ‘self-care’, ‘self-compassion’ with respect to managing mental health. Now whilst this may sound like an abstract concept (or stating the bleedin’ obvious), it is relevant to recognise that there is a neurological basis to ‘self’. If we can pin down where the self resides in the brain, and mechanisms involved in its operation, then we can target these areas and effectively train our selves to be in a better place. Much as we might go to the gym to strengthen different muscle groups and work on our core.
Surprise surprise, the self is thought to be ‘found’ within the default mode network (DMN). The interconnected regions within the DMN involve mental processes associated with, for instance, autobiographical memory. This is the repository of experiences we have had throughout our lives. The story of who ‘I’ am composites from this archive of formative events.
Indeed, there are two components to this that are governed by different parts of the DMN. This includes construction of memories – recalling the context and semantics of events brought to mind. It also involves elaboration – wherein events are recalled from an emotional and sensory perspective. It is this latter component that appears to be activated more strongly when reliving past traumatic events (as in PTSD). Furthermore, the DMN shows increased activation when exposed to threat or trauma evoking cues in individuals suffering from PTSD. The healthy pattern would be to deactivate, and allow the individual to make a rational and reasoned response.
Measuring the patterns of connectivity in these brain regions can give insight into effects of PTSD, based on the strength of that activity. It can serve to highlight which specific areas (and associated mental processes) are affected. And, importantly, can give insight into where improvements are being made as the individual goes into remission, over time as the traumatic memories are processed, or as a result of therapeutic intervention.
Clearly, some traumas, particularly sustained in childhood, or experienced in particularly horrific situations are less easily overcome. Yet for those predisposed to anxiety, or prone to mulling over events again and again, an understanding of these mechanisms can be useful to avoid slipping into a tormenting cycle of relived experience.
Various approaches are available that look to ‘train’ the networks that co-operate to enable us to function at our best. This includes, executive control (task-focus), and salience (emotional significance) networks in addition to the default mode. More detail can be found in the references highlighted on these interventions (also in part two). Nevertheless, we can highlight more ‘simple’ propositions that recur in discussion of mental health, wellbeing and performance. Namely, mindfulness and breath control! I will elaborate on the connection between this, PTSD and stress-management in the next instalment.
The point to bear in mind is that we have a semblance of control over the story of our self. Our autobiography. Yet we can become our worst critic. Or become swallowed up in the horror story of an unfolding narrative we forget we are actually the author of.
Tune into part two to find out more about how certain tried and tested techniques have been shown to help in treatment of PTSD and depression, including ways to monitor and influence our own predisposition to stress.
King, A. P., Block, S. R., Sripada, R. K., Rauch, S., Giardino, N., Favorite, T., & Liberzon, I. (2016). Altered default mode network (DMN) resting state functional connectivity following a mindfulness-based exposure therapy for post traumatic stress disorder (PTSD) in combat veterans of Afghanistan and Iraq. Depression and Anxiety, 33(4), 289–299.
Lanius RA, Terpou BA, McKinnon MC. The sense of self in the aftermath of trauma: lessons from the default mode network in post traumatic stress disorder. Eur J Psychotraumatol. 2020 Oct 23;11(1):1807703. doi: 10.1080/20008198.2020.1807703. PMID: 33178406; PMCID: PMC7594748.