The answer lies in understanding what actually happens to your brain when you're traumatised. It is far from being "all in your head" - trauma creates real, measurable changes in brain structure and function that explain why you might experience flashbacks, hypervigilance, emotional numbness or difficulty concentrating.

When I was doing my psychotherapy training, I remember starting work with my first post-traumatic stress disorder ‘case’. I had been simultaneously nervous and intrigued to work with someone who had PTSD. Trauma seemed such a big thing to tackle head on with a therapeutic protocol. It offered both hope and a challenge. As part of this training, I became experienced at spotting the key features of the diagnostic criteria for PTSD:

This similarity led me to believe that perhaps the brain processing that gets altered in the context of PTSD trauma, can also be altered to a different degree in other experiences of trauma or extreme stress and adversity. To understand if this is the case, I had to check my understanding of what happens in the brain in response to trauma and then compare. 

When you are in the traumatic experience, your brain cannot process information like it would usually do. Processing becomes primal to keep you alive. And this means an area of the brain called the amygdala becomes highly active, overriding the part of the brain that is usually running things to keep you organised and rational (to an extent at least). This more ‘cognitive’ or intellectual and strategic region of the brain is called the prefrontal cortex. When it temporarily gets suppressed by the amygdala it means you can’t access decision making, ration and impulse control as you could in usual circumstances. The amygdala is sounding the alarm loud to send distress signals to your hypothalamus. 

The extreme activation of the amygdala when traumatised or extremely stressed, can lead to it remaining more easily activated, so that you experience spikes of intense emotion, fear, tension or sense of needing to act repeatedly, or perhaps feel a heightened baseline sense of hypervigilance (1). Not only have brain imaging studies found that the amygdala can become more hyperactive after trauma, they have also shown that the amygdala can physically shrink in size (1). The significance of this is in research showing that reduced amygdala volume, corresponds with stronger fear and stress responses. 

There are different networks in the brain that consist of brain regions that are separate from each other, but connected structurally and functionally. Structurally there are bundled nerve fibres connecting different areas of the brain. Functionally, these nerve fibre ‘super highways’ allow for coordinated neural activity in different areas of the brain. Different patterns of neural activity across different established brain networks correlate with different psychological experiences. For example, increased amygdala activation after trauma can cause increased activation in regions of key brain networks responsible for directing attention like the salience network. A more threatened amygdala, corresponds with a more alert salience network, which results in more sensory, emotional and cognitive hypervigilance to threat. This is why someone only has to say ‘hosp’ for your brain to predict ‘hospital’ and have a sinking feeling if you have experienced medical trauma for example.  

We’ll explore these networks more in upcoming instalments, so be sure to subscribe to the newsletter if you haven’t already. 

Hopefully in recognising that the brain is physically affected by psychological experiences, you can garner a little compassion for yourself when you come up against difficulties that may be very likely a result of these brain changes. Even if you don’t consider yourself to have had trauma, recognising there is a continuum. In brain imaging studies it presents degree of activation (or lack of activation), rather than a brain region being on or off. That means that where your brain is calculating threat in some ways, similar patterns of firing may be happening like the one described. So demanding you ‘think better’ or shut off feelings, can be rather unfair, giving the patterns of electrical activity that are being triggered automatically.