Monday, May 24, 2010

The Brain Talk II - Traumatic Memories

I have been doing a lot of reading lately on how the brain stores memories. Most of the information is written by scientists and psychologists/psychiatrists in the field of neuroscience and is not written for the lay person. In order to understand it myself, I have translated the information into metaphors and hope that this helps my readers understand how the brain handles traumatic memories.




There are two types of memory – explicit and implicit. Explicit memory is related to events that are easily related using language. It involves facts, descriptions, concepts and ideas. It is explicit memory that enables us to tell our life story, narrate events, put experiences into words, construct a chronology and extract a meaning (Rothschild

2000, 28-29). It is easily stored into the language centers of our brain and is easily recalled. It is as if we take the memory of the event and place it tidily in one file folder, in one file drawer, into one file cabinet.

Implicit memory involves automatic states within the brain and operates unconsciously. It is implicit memory that we use when we do something we have done many times before and we no longer need to think about the action it takes, such as walking, brushing our teeth, or riding a bicycle. There may be a bridge between the two types of memory if there is a need to make sense of the unconscious action, such as trying to identify why a certain body response occurs when a person is triggered by a reminder (conscious or unconscious) of a traumatic event.

Explicit memory is also dependent on when the event occurred in a person’s development. If the brain has not developed full language and narrative abilities it may only store the event in the areas of the brain responsible for the body’s responses to the trauma.

Here is my example – When I was a year and a half old I was toddling in my grandmother’s kitchen. Someone had placed a freshly brewed (boiled/percolated) cup of coffee within my reach on the kitchen counter. I caught my finger in the handle of the cup and the hot coffee spilled down my neck and chest, resulting in third degree burns. My throat started to close up and by the time we arrived at the hospital I need to have a breathing tube. I had numerous surgeries to repair that damage which required that I be wrapped up in bandages for about six months.

I have no explicit memory of the event. The language areas of my brain were not developed. I have no visual memory of the event. All I know of that day is what my mother told me. As an adult, she was able to store the event in an area of her brain that allowed her to develop a narrative.

I have implicit memories of the event. When I was five, my mother tried to get me to wear a red hooded sweatshirt that had a tight neck. I had a complete meltdown. She tried this twice over a period of a week and then connected that I was reacting to the sensations of feeling out of control and having something over my face. As I developed, I was able to make meaning of the body memories (implicit) and have reduced the effects. I no longer have intense responses to having something over my face and around my neck. I find it uncomfortable but am able to adjust accordingly.

Even after the language and meaning making centers of the brain are developed, when traumatic events occur, our brain is flooded with large amounts of chemicals. This chemical overload will shut down the areas of the brain responsible for the explicit memories and the memories are then stored in the areas that govern sight, smell, hearing, and other body sensations. These memories are fragmented and stored in multiple areas as if the memory was torn into hundreds of puzzle pieces, placed in multiple file folders, and tucked in various file drawers. The result is that the person is unable to recall the memory in chronological order and may even mix up memories from different events, much like finding unconnected puzzle pieces and Legos in the Monopoly and Clue game boxes. It is very difficult for the person to figure out where the piece actually belongs.

What results is a survivor who cannot tell her story in a way that makes sense to the police, court or advocate. The survivor may mix up different events, be unable to relate when the incident happened, who was there, or even have blocked out certain parts of the event. For law enforcement and lawyers, who require a cohesive, sequential narrative, this can be frustrating. This may even result in a survivor being re-victimized by a system that does not understand trauma.

As advocates our job becomes assisting the person in putting together the pieces of the puzzle. Being triggered by the telling of the event is a common occurrence. It helps if the advocate can find a safe, quiet place before a court hearing where the victim can tell her story as it comes to her. Once most of the pieces are the table, then both the victim and the advocate can attempt to put them in order. Trying to have the person tell the person in chronological order right at the start would be like trying to put a puzzle together starting at the upper left corner and moving to the right and then back to the left piece by piece. The process may actually take sorting, putting a group of pieces together, discarding the pieces from another puzzle, and then trying to put the picture together. There may still be some holes when all is done but the story is there.

Finding a way to explain this process to a survivor is also helpful. You can try to find your own metaphors and make this information more accessible. Trauma survivors are often frustrated and re-traumatized by the difficulties they experience when trying to remember and make meaning out of their experiences. By understanding what is happening and having a tool box of skills to use to manage the emotions and body sensations that arise out of being triggered a victim can move to being a survivor and will be more empowered as she is able to manage and make sense out of her memories.

The following are some suggestions from the Bristol Crisis Services for Women (UK) for managing triggers or body memories of trauma –

Grounding:
• stamp your feet, grind them around on the floor to remind yourself where you are now
• look around the room, noticing the colors, the people, the shapes of things
• listen to the sounds around you: the traffic, voices, the washing machine, etc.
• feel your body, the boundary of your skin, your clothes, the chair or floor supporting you
• have an elastic band to hand - you can 'ping' it against your wrist and feel it on your skin
• tell yourself that feeling is in the now, the things you are re-experiencing were in the past.


Take care of your breathing: breathe deeply down to your diaphragm; put your hand there (just above your navel) and breathe so that your hand gets pushed up and down.
Count slowly to 5 as you breathe. When we get scared we breathe too quickly and
shallowly and our body panics. This causes dizziness, shakiness and more panic.
Breathing slowly and deeply will stop the panic.

If you have lost a sense of where you end and the rest of the world begins, rub your body so you can feel its edges, the boundary of you. Wrap yourself in a blanket, feel it around you.

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