I recommend that anyone who experiences flashbacks has loved ones who experience flashbacks or treats people with flashbacks, reads this chapter.

What Happens in the Brain During Flashbacks

“Harvard Medical School was and is at the forefront of the neuroscience revolution, and in 1994 a young psychiatrist, Scott Rauch, was appointed as the first director of the Massachusetts General Hospital Neuroimaging Laboratory. After considering the most relevant questions that this new technology could answer and reading some articles I had written, Scott asked me whether I thought we could study what happens in the brains of people who have flashbacks.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

After some of van der Kolk’s patients had told him about their flashbacks and “how upsetting it was to be suddenly hijacked by images, feelings, and sounds from the past,” he and his research team took brain scans of people while they were experiencing a flashback. And compared them to brain scans of the same people when they were feeling safe.

This research was done at Harvard Medical School. Their programs and research when it comes to neurobiology and the brain are hailed world-wide.

The Limbic Area & the Amygdala

“Our study clearly showed that when traumatized people are presented with images, sounds, or thoughts related to their particular experience, the amygdala reacts with alarm—even […] years after the event. Activation of this fear center triggers the cascade of stress hormones and nerve impulses that drive up blood pressure, heart rate, and oxygen intake—preparing the body for fight or flight.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

The limbic area is what is known as the emotional brain. It’s an area that is activated by intense emotion. Within this area is also the amygdala. The area of the brain that “warn[s] us of impending danger and to activate the body’s stress response.”

Broca’s area – The Speech Center

“Our most surprising finding was a white spot in the left frontal lobe of the cortex, in a region called Broca’s area. In this case the change in color meant that there was a significant decrease in that part of the brain. Broca’s area is one of the speech centers of the brain, which is often affected in stroke patients when the blood supply to that region is cut off. Without a functioning Broca’s area, you cannot put your thoughts and feelings into words. Our scans showed that Broca’s area went offline whenever a flashback was triggered. In other words, we had visual proof that the effects of trauma are not necessarily different from—and can overlap with—the effects of physical lesions like strokes.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I clearly remember sitting next to a therapist in the passenger seat of his car as part of exposure therapy. I was experiencing a terrible flashback. All he did was constantly ask me to tell him what was going on. I couldn’t speak. I couldn’t put it into words. His frustration grew until he finally said “if you won’t talk to me, I can’t help you.” These words haunt me to this day.

Later, when I tried to explain to him what happened, he completely dismissed me and that I couldn’t speak at that time. It was all me. I was refusing to cooperate, so there was no point in treating me.

Brodman’s Area 19 – The Visual Cortex

“When words fail, haunting images capture the experience and return as nightmares and flashbacks. In contrast to the deactivation of Broca’s area, another region, Brodmann’s area 19, lit up in our participants. This is a region in the visual cortex that registers images when they first enter the brain. We were surprised to see brain activation in this area so long after the original experience of the trauma. Under ordinary conditions raw images registered in area 19 are rapidly diffused to other brain areas that interpret the meaning of what has been seen. Once again, we were witnessing a brain region rekindled as if the trauma were actually occurring.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I have no words to accurately describe this. I usually wake up every few hours from nightmares. It’s been like this for more than 8 years now. The frequency of my flashbacks has diminished, but a few years ago they were almost constant.

It’s terrifying. A tiny part of me knows that what I’m re-experiencing is in the past. But that doesn’t help in stopping the flashback from overwhelming me in the here and now.

Deactivation of the Left Side of the Brain During a Flashback

“[…] our scans clearly showed that images of past trauma activate the right hemisphere of the brain and deactivate the left.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I think this part affected me the most. I cannot begin to express the feeling of absolute loss of rationality during a flashback. To now realize that half of my brain is deactivated during flashbacks is still hard. Rationally I understand, but my body, my feelings scream in denial. It’s a war. In my core I don’t want to accept this. Even if my brain knows perfectly well that it’s based on research. They’re facts.

“Deactivation of the left hemisphere has a direct impact on the capacity to organize experience into logical sequences and to translate our shifting feelings and perceptions into words. (Broca’s area, which blacks out during flashbacks, is on the left side.) Without sequencing we can’t identify cause and effect, grasp the long-term effects of our actions, or create coherent plans for the future. People who are very upset sometimes say they are “losing their minds.” In technical terms they are experiencing the loss of executive functioning.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

When I’m not in a flashback, I am perfectly capable of logic and reasoning, and I can easily put perceptions into words. When I’m triggered, I lose this ability. Yet my environment expects me to still be able to do what I can’t. And honestly, I expect it of myself too. Asking my environment to lower their expectations of me has proven impossible. But I can lower my own expectations of myself.

Denial: the Silent Killer

“We now know that there is another possible response to threat, which our scans aren’t yet capable of measuring. Some people simply go into denial: Their bodies register the threat, but their conscious minds go on as if nothing has happened. However, even though the mind may learn to ignore the messages from the emotional brain, the alarm signals don’t stop. The emotional brain keeps working, and stress hormones keep sending signals to the muscles to tense for action or immobilize in collapse. The physical effects on the organs go on unabated until they demand notice when they are expressed as illness. Medications, drugs, and alcohol can also temporarily dull or obliterate unbearable sensations and feelings. But the body continues to keep the score.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

This. Just this. I was not in denial of acute and chronic traumas in my past. The treatment I received for those worked well, and I still put the lessons I learned then into practice. But I was in denial about my root trauma. Until I collapsed spectacularly about 5 years ago. But the effects of denial started long before that.

Going Against a Hundred Years of Literature

“For a hundred years or more, every textbook of psychology and psychotherapy has advised that some method of talking about distressing feelings can resolve them. However, as we’ve seen, the experience of trauma itself gets in the way of being able to do that. No matter how much insight and understanding we develop, the rational brain is basically impotent to talk the emotional brain out of its own reality. “

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I’ve been trying to explain this to therapists and my environment for as long as I can remember. The assumption that because I can talk about distressing feelings and situations, and can rationally analyze what happens to me when I’m not in a flashback or unhealthy survival mode, has been a hinder.

I wonder why this is so difficult for people to accept. This is my reality. Yet over and over again I’m offered more talk therapy. And then given more diagnoses to try and explain why the talk therapy isn’t working. My greatest breakthroughs in recovering from acute trauma were during somatic therapies.

What Happens in the Brain During Flashbacks

“Harvard Medical School was and is at the forefront of the neuroscience revolution, and in 1994 a young psychiatrist, Scott Rauch, was appointed as the first director of the Massachusetts General Hospital Neuroimaging Laboratory. After considering the most relevant questions that this new technology could answer and reading some articles I had written, Scott asked me whether I thought we could study what happens in the brains of people who have flashbacks.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

After some of van der Kolk’s patients had told him about their flashbacks and “how upsetting it was to be suddenly hijacked by images, feelings, and sounds from the past,” he and his research team took brain scans of people while they were experiencing a flashback. And compared them to brain scans of the same people when they were feeling safe.

This research was done at Harvard Medical School. Their programs and research when it comes to neurobiology and the brain are hailed world-wide.

The Limbic Area & the Amygdala

“Our study clearly showed that when traumatized people are presented with images, sounds, or thoughts related to their particular experience, the amygdala reacts with alarm—even […] years after the event. Activation of this fear center triggers the cascade of stress hormones and nerve impulses that drive up blood pressure, heart rate, and oxygen intake—preparing the body for fight or flight.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

The limbic area is what is known as the emotional brain. It’s an area that is activated by intense emotion. Within this area is also the amygdala. The area of the brain that “warn[s] us of impending danger and to activate the body’s stress response.”

I have written before that trauma can affect people physically. “Exposure to complex trauma in early childhood leads to structural and functional brain changes. […] Proven structural changes include enlargement of the amygdala, the alarm center of the brain.”

Broca’s area – The Speech Center

“Our most surprising finding was a white spot in the left frontal lobe of the cortex, in a region called Broca’s area. In this case the change in color meant that there was a significant decrease in that part of the brain. Broca’s area is one of the speech centers of the brain, which is often affected in stroke patients when the blood supply to that region is cut off. Without a functioning Broca’s area, you cannot put your thoughts and feelings into words. Our scans showed that Broca’s area went offline whenever a flashback was triggered. In other words, we had visual proof that the effects of trauma are not necessarily different from—and can overlap with—the effects of physical lesions like strokes.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I remember clearly sitting next to a therapist in the passenger seat of his car as part of exposure therapy. I was experiencing a terrible flashback. All he did was constantly ask me to tell him what was going on. I couldn’t speak. I couldn’t put it into words. His frustration grew until he finally said “If you won’t talk to me, I can’t help you.” These words haunt me to this day.

Later, when I tried to explain to him what happened, he completely dismissed me and that I couldn’t speak at that time. It was all me. I was refusing to cooperate, so there was no point in treating me.

“Even years later traumatized people often have enormous difficulty telling other people what has happened to them. Their bodies reexperience terror, rage, and helplessness, as well as the impulse to fight or flee, but these feelings are almost impossible to articulate. Trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I can talk about what happened to me. What was done to me? But in order to do that I need to shut off all feeling. Which is triggering in itself. It turns out I’m not alone in this. It’s called denial and comes up a little later in this chapter.

Brodman’s Area 19 – The Visual Cortex

“When words fail, haunting images capture the experience and return as nightmares and flashbacks. In contrast to the deactivation of Broca’s area, another region, Brodmann’s area 19, lit up in our participants. This is a region in the visual cortex that registers images when they first enter the brain. We were surprised to see brain activation in this area so long after the original experience of the trauma. Under ordinary conditions raw images registered in area 19 are rapidly diffused to other brain areas that interpret the meaning of what has been seen. Once again, we were witnessing a brain region rekindled as if the trauma were actually occurring.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I have no words to accurately describe this. I usually wake up every few hours from nightmares. It’s been like this for more than 8 years now. The frequency of my flashbacks has diminished, but a few years ago they were almost constant.

It’s terrifying. A tiny part of me knows that what I’m re-experiencing is in the past. But that doesn’t help me in stopping the flashback from overwhelming me in the here and now.

“Similar sensations often trigger a flashback that brings them back into consciousness, apparently unmodified by the passage of time.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

Since I was a little kid it was explained to me that I would experience things that would scare me or make me nervous. I was told and believed that this would go away with the passage of time. Mostly they never did.

Deactivation of the Left Side of the Brain During a Flashback

“[…] our scans clearly showed that images of past trauma activate the right hemisphere of the brain and deactivate the left.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I think this part affected me the most. I cannot begin to express the feeling of absolute loss of rationality during a flashback. To now realize that half of my brain is deactivated during flashbacks is still hard. Rationally I understand, but my body, my feelings scream in denial. It’s a war. In my core I don’t want to accept this. Even if my brain knows perfectly well that it’s based on research. They’re facts.

“Deactivation of the left hemisphere has a direct impact on the capacity to organize experience into logical sequences and to translate our shifting feelings and perceptions into words. (Broca’s area, which blacks out during flashbacks, is on the left side.) Without sequencing we can’t identify cause and effect, grasp the long-term effects of our actions, or create coherent plans for the future. People who are very upset sometimes say they are “losing their minds.” In technical terms they are experiencing the loss of executive functioning.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

When I’m not in a flashback, I am perfectly capable of logic and reasoning, and I can easily put perceptions into words. When I’m triggered, I lose this ability. Yet my environment expects me to still be able to do what I can’t. And honestly, I expect it of myself too. Asking my environment to lower their expectations of me has proven impossible. But I can lower my own expectations of myself.

Trauma Interferes with Awareness

When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present. But because their left brain is not working very well, they may not be aware that they are reexperiencing and reenacting the past—they are just furious, terrified, enraged, ashamed, or frozen. After the emotional storm passes, they may look for something or somebody to blame for it. They behaved the way they did because you were ten minutes late, or because you burned the potatoes, or because you “never listen to me.” Of course, most of us have done this from time to time, but when we cool down, we hopefully can admit our mistake. Trauma interferes with this kind of awareness, and, over time, our research demonstrated why.

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I REALLY want to skip ahead and read the research into this. Not just for myself. By now I’m fairly aware of my reactions and behavior. I still can’t always stop it from happening, but I have always tried to go back and explain my reactions. These days the people closest to me accept this of me. And when they experience it themselves, have started to reciprocate. It’s a process. One that is incredibly helpful to me.

The Essence Does Not Equal Integration

“I am continually impressed by how difficult it is for people who have gone through the unspeakable to convey the essence of their experience. It is so much easier for them to talk about what has been done to them—to tell a story of victimization and revenge—than to notice, feel, and put into words the reality of their internal experience. Our scans had revealed how their dread persisted and could be triggered by multiple aspects of daily experience. They had not integrated their experience into the ongoing stream of their life. They continued to be “there” and did not know how to be “here”—fully alive in the present.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I can’t adequately explain the impact of this on me. I can convey the essence of my experience. So in that sense I’m much further along than some. Yet when I do convey the essence, it’s treated as though it’s nothing. Reading that an expert in the field of trauma is impressed by people who can is ambiguous. Maybe because I trivialize myself in this. I don’t find it impressive at all; it is a basic necessity in order to survive for me.

The Personal

I objectively have experienced complex trauma and chronic trauma since early childhood.

Yet whenever I have tried to talk to my environment about the possibility that this might have affected my brain physically, I am ignored or asked not to consider it until it’s proven by an actual brain scan of my brain. And mental health care professionals here in Aruba have refused to even discuss these possibilities with me, except as a sign of another disorder.

I am told they work according to evidence-based approaches, yet when I show evidence, by world-renowned scientists and research institutes such as Harvard, it’s still not enough. What will it take?

And even if there would be irrefutable proof, what then?

Being Asked to Provide Evidence, Then Promptly Ignoring the Evidence

This is particularly triggering to me for a rather bizarre reason. I come from a family where law is heavily respected and a large part of my family have studied law. And the other side of my family comes from generations of people who have studied at University. So logic and proof were par for the course from both sides of my family.

Since childhood, I learned a very important lesson, that I still haven’t completely unlearned. If I can’t prove something, it can’t be true. That’s fine in legal professions or in academic circles. But not when it comes to dealing with children and their emotions and reactions.

A Plea to Anyone Who Deals With Traumatized People

Most people don’t react differently for no reason. I beg of anyone, whether you’re a parent or a partner or even a therapist, to please stop putting the burden of proof on the person who’s traumatized. They’re traumatized; that’s all the proof you need in order to support them in their journey to find the proof they need to resolve their experiences.

And if along the way you help them find proof that can be used in a court of law, or to help them get therapies that actually work, that’s just a bonus.

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In a little over a week, I and the (mental) health director of the Jeffry Stijn Foundation for Mental Health and Patient Advocacy, will be attending the 34th Annual Boston International Trauma Conference virtually. A few days ago I decided to read Bessel van der Kolk‘s “The Body Keeps the Score” and journal as I read.

I was planning on writing a summary post after I was done. But Chapter 3: Looking into the Brain. The Neuroscience Revolution, demanded immediate attention.

Here’s an excerpt from the original post.

Chapter 3: Looking into the Brain. The Neuroscience Revolution

People have physical reactions during Flashbacks. Heart rate and blood pressure go up. The fear center of the brain gets activated. Being able to speak goes out the window. Images flash by as if they are happening here and now. Not in the past. It feels like losing one’s mind.

There are brain scans made 30 years ago at Harvard University that show why this is.

I recommend that anyone who experiences flashbacks has loved ones who experience flashbacks or treats people with flashbacks, reads this chapter.

What Happens in the Brain During Flashbacks

“Harvard Medical School was and is at the forefront of the neuroscience revolution, and in 1994 a young psychiatrist, Scott Rauch, was appointed as the first director of the Massachusetts General Hospital Neuroimaging Laboratory. After considering the most relevant questions that this new technology could answer and reading some articles I had written, Scott asked me whether I thought we could study what happens in the brains of people who have flashbacks.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

After some of van der Kolk’s patients had told him about their flashbacks and “how upsetting it was to be suddenly hijacked by images, feelings, and sounds from the past,” he and his research team took brain scans of people while they were experiencing a flashback. And compared them to brain scans of the same people when they were feeling safe.

This research was done at Harvard Medical School. Their programs and research when it comes to neurobiology and the brain are hailed world-wide.

The Limbic Area & the Amygdala

“Our study clearly showed that when traumatized people are presented with images, sounds, or thoughts related to their particular experience, the amygdala reacts with alarm—even […] years after the event. Activation of this fear center triggers the cascade of stress hormones and nerve impulses that drive up blood pressure, heart rate, and oxygen intake—preparing the body for fight or flight.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

The limbic area is what is known as the emotional brain. It’s an area that is activated by intense emotion. Within this area is also the amygdala. The area of the brain that “warn[s] us of impending danger and to activate the body’s stress response.”

Broca’s area – The Speech Center

“Our most surprising finding was a white spot in the left frontal lobe of the cortex, in a region called Broca’s area. In this case the change in color meant that there was a significant decrease in that part of the brain. Broca’s area is one of the speech centers of the brain, which is often affected in stroke patients when the blood supply to that region is cut off. Without a functioning Broca’s area, you cannot put your thoughts and feelings into words. Our scans showed that Broca’s area went offline whenever a flashback was triggered. In other words, we had visual proof that the effects of trauma are not necessarily different from—and can overlap with—the effects of physical lesions like strokes.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I clearly remember sitting next to a therapist in the passenger seat of his car as part of exposure therapy. I was experiencing a terrible flashback. All he did was constantly ask me to tell him what was going on. I couldn’t speak. I couldn’t put it into words. His frustration grew until he finally said “if you won’t talk to me, I can’t help you.” These words haunt me to this day.

Later, when I tried to explain to him what happened, he completely dismissed me and that I couldn’t speak at that time. It was all me. I was refusing to cooperate, so there was no point in treating me.

Brodman’s Area 19 – The Visual Cortex

“When words fail, haunting images capture the experience and return as nightmares and flashbacks. In contrast to the deactivation of Broca’s area, another region, Brodmann’s area 19, lit up in our participants. This is a region in the visual cortex that registers images when they first enter the brain. We were surprised to see brain activation in this area so long after the original experience of the trauma. Under ordinary conditions raw images registered in area 19 are rapidly diffused to other brain areas that interpret the meaning of what has been seen. Once again, we were witnessing a brain region rekindled as if the trauma were actually occurring.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I have no words to accurately describe this. I usually wake up every few hours from nightmares. It’s been like this for more than 8 years now. The frequency of my flashbacks has diminished, but a few years ago they were almost constant.

It’s terrifying. A tiny part of me knows that what I’m re-experiencing is in the past. But that doesn’t help in stopping the flashback from overwhelming me in the here and now.

Deactivation of the Left Side of the Brain During a Flashback

“[…] our scans clearly showed that images of past trauma activate the right hemisphere of the brain and deactivate the left.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I think this part affected me the most. I cannot begin to express the feeling of absolute loss of rationality during a flashback. To now realize that half of my brain is deactivated during flashbacks is still hard. Rationally I understand, but my body, my feelings scream in denial. It’s a war. In my core I don’t want to accept this. Even if my brain knows perfectly well that it’s based on research. They’re facts.

“Deactivation of the left hemisphere has a direct impact on the capacity to organize experience into logical sequences and to translate our shifting feelings and perceptions into words. (Broca’s area, which blacks out during flashbacks, is on the left side.) Without sequencing we can’t identify cause and effect, grasp the long-term effects of our actions, or create coherent plans for the future. People who are very upset sometimes say they are “losing their minds.” In technical terms they are experiencing the loss of executive functioning.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

When I’m not in a flashback, I am perfectly capable of logic and reasoning, and I can easily put perceptions into words. When I’m triggered, I lose this ability. Yet my environment expects me to still be able to do what I can’t. And honestly, I expect it of myself too. Asking my environment to lower their expectations of me has proven impossible. But I can lower my own expectations of myself.

Denial: the Silent Killer

“We now know that there is another possible response to threat, which our scans aren’t yet capable of measuring. Some people simply go into denial: Their bodies register the threat, but their conscious minds go on as if nothing has happened. However, even though the mind may learn to ignore the messages from the emotional brain, the alarm signals don’t stop. The emotional brain keeps working, and stress hormones keep sending signals to the muscles to tense for action or immobilize in collapse. The physical effects on the organs go on unabated until they demand notice when they are expressed as illness. Medications, drugs, and alcohol can also temporarily dull or obliterate unbearable sensations and feelings. But the body continues to keep the score.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

This. Just this. I was not in denial of acute and chronic traumas in my past. The treatment I received for those worked well, and I still put the lessons I learned then into practice. But I was in denial about my root trauma. Until I collapsed spectacularly about 5 years ago. But the effects of denial started long before that.

Going Against a Hundred Years of Literature

“For a hundred years or more, every textbook of psychology and psychotherapy has advised that some method of talking about distressing feelings can resolve them. However, as we’ve seen, the experience of trauma itself gets in the way of being able to do that. No matter how much insight and understanding we develop, the rational brain is basically impotent to talk the emotional brain out of its own reality. “

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I’ve been trying to explain this to therapists and my environment for as long as I can remember. The assumption that because I can talk about distressing feelings and situations, and can rationally analyze what happens to me when I’m not in a flashback or unhealthy survival mode, has been a hinder.

I wonder why this is so difficult for people to accept. This is my reality. Yet over and over again I’m offered more talk therapy. And then given more diagnoses to try and explain why the talk therapy isn’t working. My greatest breakthroughs in recovering from acute trauma were during somatic therapies.

What Happens in the Brain During Flashbacks

“Harvard Medical School was and is at the forefront of the neuroscience revolution, and in 1994 a young psychiatrist, Scott Rauch, was appointed as the first director of the Massachusetts General Hospital Neuroimaging Laboratory. After considering the most relevant questions that this new technology could answer and reading some articles I had written, Scott asked me whether I thought we could study what happens in the brains of people who have flashbacks.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

After some of van der Kolk’s patients had told him about their flashbacks and “how upsetting it was to be suddenly hijacked by images, feelings, and sounds from the past,” he and his research team took brain scans of people while they were experiencing a flashback. And compared them to brain scans of the same people when they were feeling safe.

This research was done at Harvard Medical School. Their programs and research when it comes to neurobiology and the brain are hailed world-wide.

The Limbic Area & the Amygdala

“Our study clearly showed that when traumatized people are presented with images, sounds, or thoughts related to their particular experience, the amygdala reacts with alarm—even […] years after the event. Activation of this fear center triggers the cascade of stress hormones and nerve impulses that drive up blood pressure, heart rate, and oxygen intake—preparing the body for fight or flight.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

The limbic area is what is known as the emotional brain. It’s an area that is activated by intense emotion. Within this area is also the amygdala. The area of the brain that “warn[s] us of impending danger and to activate the body’s stress response.”

I have written before that trauma can affect people physically. “Exposure to complex trauma in early childhood leads to structural and functional brain changes. […] Proven structural changes include enlargement of the amygdala, the alarm center of the brain.”

Broca’s area – The Speech Center

“Our most surprising finding was a white spot in the left frontal lobe of the cortex, in a region called Broca’s area. In this case the change in color meant that there was a significant decrease in that part of the brain. Broca’s area is one of the speech centers of the brain, which is often affected in stroke patients when the blood supply to that region is cut off. Without a functioning Broca’s area, you cannot put your thoughts and feelings into words. Our scans showed that Broca’s area went offline whenever a flashback was triggered. In other words, we had visual proof that the effects of trauma are not necessarily different from—and can overlap with—the effects of physical lesions like strokes.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I remember clearly sitting next to a therapist in the passenger seat of his car as part of exposure therapy. I was experiencing a terrible flashback. All he did was constantly ask me to tell him what was going on. I couldn’t speak. I couldn’t put it into words. His frustration grew until he finally said “If you won’t talk to me, I can’t help you.” These words haunt me to this day.

Later, when I tried to explain to him what happened, he completely dismissed me and that I couldn’t speak at that time. It was all me. I was refusing to cooperate, so there was no point in treating me.

“Even years later traumatized people often have enormous difficulty telling other people what has happened to them. Their bodies reexperience terror, rage, and helplessness, as well as the impulse to fight or flee, but these feelings are almost impossible to articulate. Trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I can talk about what happened to me. What was done to me? But in order to do that I need to shut off all feeling. Which is triggering in itself. It turns out I’m not alone in this. It’s called denial and comes up a little later in this chapter.

Brodman’s Area 19 – The Visual Cortex

“When words fail, haunting images capture the experience and return as nightmares and flashbacks. In contrast to the deactivation of Broca’s area, another region, Brodmann’s area 19, lit up in our participants. This is a region in the visual cortex that registers images when they first enter the brain. We were surprised to see brain activation in this area so long after the original experience of the trauma. Under ordinary conditions raw images registered in area 19 are rapidly diffused to other brain areas that interpret the meaning of what has been seen. Once again, we were witnessing a brain region rekindled as if the trauma were actually occurring.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I have no words to accurately describe this. I usually wake up every few hours from nightmares. It’s been like this for more than 8 years now. The frequency of my flashbacks has diminished, but a few years ago they were almost constant.

It’s terrifying. A tiny part of me knows that what I’m re-experiencing is in the past. But that doesn’t help me in stopping the flashback from overwhelming me in the here and now.

“Similar sensations often trigger a flashback that brings them back into consciousness, apparently unmodified by the passage of time.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

Since I was a little kid it was explained to me that I would experience things that would scare me or make me nervous. I was told and believed that this would go away with the passage of time. Mostly they never did.

Deactivation of the Left Side of the Brain During a Flashback

“[…] our scans clearly showed that images of past trauma activate the right hemisphere of the brain and deactivate the left.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I think this part affected me the most. I cannot begin to express the feeling of absolute loss of rationality during a flashback. To now realize that half of my brain is deactivated during flashbacks is still hard. Rationally I understand, but my body, my feelings scream in denial. It’s a war. In my core I don’t want to accept this. Even if my brain knows perfectly well that it’s based on research. They’re facts.

“Deactivation of the left hemisphere has a direct impact on the capacity to organize experience into logical sequences and to translate our shifting feelings and perceptions into words. (Broca’s area, which blacks out during flashbacks, is on the left side.) Without sequencing we can’t identify cause and effect, grasp the long-term effects of our actions, or create coherent plans for the future. People who are very upset sometimes say they are “losing their minds.” In technical terms they are experiencing the loss of executive functioning.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

When I’m not in a flashback, I am perfectly capable of logic and reasoning, and I can easily put perceptions into words. When I’m triggered, I lose this ability. Yet my environment expects me to still be able to do what I can’t. And honestly, I expect it of myself too. Asking my environment to lower their expectations of me has proven impossible. But I can lower my own expectations of myself.

Trauma Interferes with Awareness

When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present. But because their left brain is not working very well, they may not be aware that they are reexperiencing and reenacting the past—they are just furious, terrified, enraged, ashamed, or frozen. After the emotional storm passes, they may look for something or somebody to blame for it. They behaved the way they did because you were ten minutes late, or because you burned the potatoes, or because you “never listen to me.” Of course, most of us have done this from time to time, but when we cool down, we hopefully can admit our mistake. Trauma interferes with this kind of awareness, and, over time, our research demonstrated why.

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I REALLY want to skip ahead and read the research into this. Not just for myself. By now I’m fairly aware of my reactions and behavior. I still can’t always stop it from happening, but I have always tried to go back and explain my reactions. These days the people closest to me accept this of me. And when they experience it themselves, have started to reciprocate. It’s a process. One that is incredibly helpful to me.

The Essence Does Not Equal Integration

“I am continually impressed by how difficult it is for people who have gone through the unspeakable to convey the essence of their experience. It is so much easier for them to talk about what has been done to them—to tell a story of victimization and revenge—than to notice, feel, and put into words the reality of their internal experience. Our scans had revealed how their dread persisted and could be triggered by multiple aspects of daily experience. They had not integrated their experience into the ongoing stream of their life. They continued to be “there” and did not know how to be “here”—fully alive in the present.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I can’t adequately explain the impact of this on me. I can convey the essence of my experience. So in that sense I’m much further along than some. Yet when I do convey the essence, it’s treated as though it’s nothing. Reading that an expert in the field of trauma is impressed by people who can is ambiguous. Maybe because I trivialize myself in this. I don’t find it impressive at all; it is a basic necessity in order to survive for me.

The Personal

I objectively have experienced complex trauma and chronic trauma since early childhood.

Yet whenever I have tried to talk to my environment about the possibility that this might have affected my brain physically, I am ignored or asked not to consider it until it’s proven by an actual brain scan of my brain. And mental health care professionals here in Aruba have refused to even discuss these possibilities with me, except as a sign of another disorder.

I am told they work according to evidence-based approaches, yet when I show evidence, by world-renowned scientists and research institutes such as Harvard, it’s still not enough. What will it take?

And even if there would be irrefutable proof, what then?

Being Asked to Provide Evidence, Then Promptly Ignoring the Evidence

This is particularly triggering to me for a rather bizarre reason. I come from a family where law is heavily respected and a large part of my family have studied law. And the other side of my family comes from generations of people who have studied at University. So logic and proof were par for the course from both sides of my family.

Since childhood, I learned a very important lesson, that I still haven’t completely unlearned. If I can’t prove something, it can’t be true. That’s fine in legal professions or in academic circles. But not when it comes to dealing with children and their emotions and reactions.

A Plea to Anyone Who Deals With Traumatized People

Most people don’t react differently for no reason. I beg of anyone, whether you’re a parent or a partner or even a therapist, to please stop putting the burden of proof on the person who’s traumatized. They’re traumatized; that’s all the proof you need in order to support them in their journey to find the proof they need to resolve their experiences.

And if along the way you help them find proof that can be used in a court of law, or to help them get therapies that actually work, that’s just a bonus.

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Julie Faruba

Julie is a renaissance woman. Mental health patient advocate. Certified compliance professional. Avid reader. Amateur writer. Passionate dancer. Animal friend. Life-long student. Free speech proponent. Human rights champion. Devil’s advocate debater. Complex Trauma Experience Expert.

jsfaruba.com

Why do I need service dogs? Because I, like many, am on the road to recovery from complex trauma. I have been high-functioning most of my life. I’ve found ways to manage or cope with stress or trauma, but I’ve never actually dealt with the root causes. And I’m far from alone.

High-functioning mental illness 

We’re workaholics; the rocks others build on. We’re responsible, empathetic, and understanding. We’re on personal journeys and have personal missions. We do well in school, at work, or in social situations. We’re critical thinkers that find structural solutions; we’re bridge-builders. Leaders in times of crisis or change. The founders of good initiatives. The shoulders to cry on, the confidants, the advisors.

That’s our strength, as well as our weakness. We’re high-functioning alcoholics. Our amazing work ethic is actually an unhealthy way to avoid dealing with our untreated traumas. We excel in hobbies or physical activities because we’re desperately trying to feel better. Our empathy, understanding, and responsible natures are partially due to coping with stress and trauma.

We fight the good fight because no one fought for us. We are depressed. We are anxious. We are hyper-vigilant. The simplest things take us monstrous effort. We are burned out.

Not getting the help we really need, when we need it

The flip side of being high functioning is that when we reach our breaking point, we often don’t get the help, understanding, or support that we need. Most people can’t accept that we come across as well-adjusted, but we’re just managing our disease or even surviving day-to-day. That we desperately need AND deserve help and support.

Not getting help can lead to self-harm and self-destructive behavior

Self-harm is not uncommon for people who suffer from complex trauma disorders. Self-destructive behavior is definitely not unheard of. Especially in small communities with limited resources.

“Have you heard…?”
“Can you believe…!” 
“Well, I never!” 

The amount of gossip and surprised reactions when high-functioning people start falling apart is a normal day in the park for us. We’re not surprised. We can most definitely believe it. Most of us are painfully aware that we could be next. Or have already been there? It’s also the reason why a lot of high-functioning people don’t come out openly as having poor mental health or mental illness.

There’s already a taboo when it comes to talking about trauma. There’s a taboo on being adversely affected by trauma. There’s a stigma on seeking professional help for poor mental health or mental illness. But the social consequences when you haven’t dealt with trauma and you ultimately turn to self-harm or self-destructive behavior? Being the object of ridicule and social ostracism because you didn’t get the help you needed when you needed it. There’s nothing quite like it.

The ultimate “remedy”

That’s what I write about in a nutshell: my road to recovery. 

I write:

• Informative articles
• Op-ed pieces
• Personal blog entries
• Articles about advocacy and activism

But mostly I write about human nature and human rights. Because at the end of the day, my complex trauma is just a tiny part of who I am. 

I am a Renaissance Woman and Modern Entrepreneur. An avid reader, amateur writer, patient advocate, and complex trauma experience expert. A lifelong student of human nature and human rights.

My background may be complex. My disease may be complex. My life may be complex.

But at the end of the day, I’m Just Julie. A human being just like you.

Suicide is the last stop for people like me. I, and many like me, have lost a lot of people to suicide. While the rest of my environment is shocked, grieving, and taken by surprise, I am shocked, suppressing my grief, and not surprised at all. These people are my people. These people are my tribe.

I tried to hang myself when I was 12. It was pure chance that I failed.

No one knew at the time. And no one suspected or noticed how badly I was doing. My suicide attempt wasn’t a cry for help. It wasn’t a way to get attention. It was the only escape for me from an impossibly bleak situation and immediate future.

Sometimes failure is a good thing

I didn’t tell anyone about my suicide attempt until the following year. 

I connected with a cousin who was a lot like me in a lot of ways. He was also well-adjusted, but silently suffering from depression, anxiety, and suicidal ideation. Like me, his attempts at seeking support or understanding had worked counter-productively.

To me this connection was profound. It had taken me 14 years, but here was one person who got me. If there was one, there might be more. If there were more, there might be others who knew why I was the way I was. And maybe someone, somewhere had figured out how to live with being like me.

It’s a journey, not a destination

And that’s what I’ve been doing ever since. What I’ve been working towards. Not always consciously. Sometimes with detrimental results. Riddled with periods of complete and utter dejection; times when I cannot function.

But I also learned a lot. Met people who know a lot. Learned a lot of life lessons. Tried a lot of different things. I’m nowhere near my destination, but I’m on my way.

Self-Actualization

At various times in my life, I have been trying to self-actualize. And that helps me manage my disease better than anything else I tried in the past 42 years.

Part of my quest has been to learn about trauma and trauma disorders. That’s what led me to re-frame a key question.

What everyone has always asked, and what I’ve always wondered is:

What is wrong with me?

-Me, the first 42 years of my life

Current research suggests that when dealing with complex trauma it helps to re-frame the question into:

What happened to me that makes me the way I am?

-Me, the past 3 years

Since childhood, I have been wondering what is wrong with me. I have been told over and over that there’s something wrong with me. Have been punished for saying the wrong things or doing the wrong things. 

It turns out that what is ‘wrong’ with me is that I have perfectly normal reactions to abnormal, traumatic situations. What’s ‘wrong’ with me is that I have never dealt with my traumatic past, just been trying to fix symptoms. Not finding or treating the root causes.

Road to recovery

That’s what I write about in a nutshell: my road to recovery. 

I write:

• Informative articles
• Op-ed pieces
• Personal blog entries
• Articles about advocacy and activism

But mostly I write about human nature and human rights. Because at the end of the day, my complex trauma is just a tiny part of who I am. 

I am a Renaissance Woman and Modern Entrepreneur. An avid reader, amateur writer, patient advocate, and complex trauma experience expert. A lifelong student of human nature and human rights.

My background may be complex. My disease may be complex. My life may be complex.

But at the end of the day, I’m Just Julie. A human being just like you.

Julie Faruba

Julie is a renaissance woman. Mental health patient advocate. Certified compliance professional. Avid reader. Amateur writer. Passionate dancer. Animal friend. Life-long student. Free speech proponent. Human rights champion. Devil’s advocate debater. Complex Trauma Experience Expert.

jsfaruba.com