Trauma and Memory: Brain and Body in a search for the living pasta practical guide for understanding and working with traumatic memory

Trauma and Memory: Brain and Body in a search for the living past a practical guide for understanding and working with traumatic memory

In 1889, Charcot’s student Pierre Janet wrote the first book on what we now would call PTSD, L’automatisme psychologique, a in which he argued that trauma is held in procedural memory—in automatic actions and reactions, sensations and attitudes, and that trauma is replayed and reenacted as visceral sensations (anxiety and panic), body movements, or visual images (nightmares and flashbacks).

Janet put the issue of memory front and center in dealing with trauma: An event only becomes a trauma when overwhelming emotions interfere with proper memory processing. Afterward, traumatized patients react to reminders of the trauma with emergency responses appropriate to the original threat, but these reactions now are completely out of place—like ducking in panic under the table when a drinking glass falls on the floor, or going into a rage when a child starts crying.

For well over a century we have understood that the imprints of trauma are stored not as narratives about bad things that happened sometime in the past, but as physical sensations that are experienced as immediate life threats—right now.

People become obsessed unconsciously with the horror they consciously want to leave behind, but they keep behaving and feeling as if it is still going on. Unable to put the trauma behind them, their energy is absorbed by keeping their emotions under control at the expense of paying attention to the demands of the present.

Trauma can be resolved by reliving the events in a hypnotic trance state. By safely replaying the old events in their minds and then constructing an imaginary satisfactory conclusion—something they had been unable to do during the original event because they had been too overwhelmed by helplessness and horror—they could begin to fully realize that they had, in fact, survived the trauma and could resume their lives.

Researchers learned from bitter experience that the traumatized women under their care could not be cured by reasoning or insight, behavior modification or punishment.

Demonstrating that fully understanding trauma is about knowing trauma is imprinted in the body, and that in order to heal one needs to create a sheltered trance state from which one can safely observe the horrific past. Adding in the critical element of exploring the subtle physical imprints of trauma and focusing on reconnecting the body with the mind.

An experience becomes traumatic when the human organism becomes overwhelmed and reacts with helplessness and paralysis—when there is absolutely nothing you can do to alter the outcome of events, the whole system comes crashing down.

Understanding the critical role of physical sensations and bodily action, post-traumatic actions do not only consist of gross behaviors such as blowing up at anyone who offends you or becoming paralyzed when you are scared, but also in imperceptibly holding your breath, tensing your muscles, or tightening your sphincters. The entire organism—body, mind, and spirit—becomes stuck and continues to behave as if there is a clear and present danger.

The brain is programmed by mental experiences that are expressed in the body. Emotions are communicated in facial expressions and body postures: Anger is experienced by clenched fists and gritted teeth; fear is rooted in tightened muscles and shallow breath.

Thoughts and emotions are accompanied by changes in our muscle tension, and in order to change habitual patterns one has to change the somatic loops that connect sensations, thoughts, memories, and actions. The primary task of therapists then is to observe and deal with those somatic changes.

Becoming aware of inner sensations, our primordial feelings, allows us access to the direct experience of our own living body along a scale that ranges from pleasure to pain, feelings that originate at the deepest levels of the brain stem rather than the cerebral cortex.

This is so important to understand, because traumatized people are terrified of what’s going on inside of them. Asking them to focus on their breath may precipitate a panic reaction; simply requesting that they keep still often only increases their agitation.

The areas of the brain that are devoted to self-awareness (the medial prefrontal cortex) and body awareness (the insula) often are shrunk in people with chronic PTSD—the body/ mind/ brain has learned to shut itself down. This shutting down carries an enormous price: The same brain areas that convey pain and distress are also responsible for transmitting feelings of joy, pleasure, purpose, and relational connection.

(Insert the hypnotic blog post about hypnosis working on these areas)

Traumatic imprints stealthily force themselves on us, not so much as stories or conscious memories, but as emotions, sensations, and “procedures”—things that the body automatically does, as psychological automatisms.

Good therapy consists of learning to call up the felt sense without becoming overwhelmed by what’s lurking inside. The most important sentences in any therapy are “notice that” and “notice what happens next.”

Allowing yourself to observe your inner processes activates brain pathways that connect the rational and the emotional parts of the brain, and this is the only known pathway through which a person can consciously rearrange the perceptual system of the brain. In order to be in touch with your self, you have to activate the anterior insula, the critical brain area responsible for how you feel about your body and your self.

Somatic Experiencing is not primarily about “unlearning” conditioned responses to trauma by rehashing them, but about creating novel experiences that contradict overwhelming feelings of helplessness and replacing them with a sense of ownership of physical reactions and sensations. This work lays the frozen shame, grief, rage, and sense of loss to rest by helping trauma’s explosive assault on the body to be completed and resolved.

Despite the seemingly boundless human predilection to inflict suffering and trauma on others, we are also capable of surviving, adapting to, and eventually transforming traumatic experiences. Seasoned therapists utilize this innate capacity for resilience and healing to support their work with those suffering from the aftermath of life-threatening and overwhelming events.

Seasoned therapists utilize this innate capacity for resilience and healing to support their work with those suffering from the aftermath of life-threatening and overwhelming events. These incidents include (but are by no means limited to) war, assault, molestation, abuse, accidents, invasive medical procedures, natural disasters, and witnessing a serious injury or sudden death of a loved one.

All of these “shocks” to the organism can alter a person’s biological, psychological, and social equilibrium to such a degree that the memory of one particular event comes to taint, and dominate, all other experiences, spoiling an appreciation of the present moment.

The resulting tyranny of the past interferes with the ability to focus effectively on both new and familiar situations. When people pay selective attention to the riveting reminders of their past, sleep becomes the enemy and life becomes colorless.

Most contemporary psychotherapies have been guided by various cognitive behavioral approaches. these therapeutic traditions do address certain dysfunctions related to trauma, they are unable to reach its primal core.

They do not sufficiently address the essential body and brain mechanisms that are impacted by trauma. Alas, this leaves the most basic human need and drive for healing largely unmet.

Increasingly, therapists are being drawn to work with traumatic memories as various techniques (and their offshoots) are becoming widely known, taught, and practiced. These various approaches have arrived on the scene in this approximate chronological order: hypnosis, NLP, Somatic Experiencing (SE), eye movement desensitization reprocessing (EMDR), and various “energy psychologies” (e.g., point tapping).

Without a firm grasp of the multidimensional structure of traumatic memory as it is stored in the brain and held in the body, the therapist is often left floundering in the swamplands of ambiguity and uncertainty.

Conscious, explicit memory is only the proverbial tip of a very deep and mighty iceberg. It barely hints at the submerged strata of primal implicit experience that moves and motivates us in ways that the conscious mind can only begin to imagine.

But imagine we should, and understand we must, if we are to work effectively and wisely with trauma and its memory traces in both mind and body.

Memory is a continual reconstruction, more akin to the wayward, wildly unpredictable electrons in Heisenberg’s uncertainty principle. Just as the very act of observing electrons changes their position or momentum, so does the warp and woof of memory interweave to yield a soft fabric that changes hue and contour with the movement of light and shadow throughout the day and over the seasons.

Indeed, recent research resoundingly demonstrates that memory is a reconstructive process that is continuously selecting, adding, deleting, rearranging, and updating information—all to serve the ongoing adaptive process of survival and living.

What has been poorly understood in clinical work with traumatic memories is that our present mood, emotions, and somatic sensations (generated for whatever reasons) profoundly influence what we are “remembering.”

Remembered images and thoughts that appear in our field of awareness are evoked and (unconsciously) selected to match our current emotional state. Our current moods and sensations play a key role in how we remember a particular event—they structure our evolving relationship to these “memories,” as well as how we deal with and reconstruct them anew.

Memory, when reduced to its most vital function, has to do with securing a future that chooses selectively from the past and builds on what was effective, while not repeating those responses that were deleterious or harmful—in short, securing a future that is influenced, but not overly constrained, by our history.

Through memory we maintain a thread of continuity by linking present with past. In the ongoing process of comparing similarities and differences, times of threat and those of safety and contentment, as well as important accomplishments and failures, we sort through and then reorganize this information to shape our present and upcoming choices. In this way we aspire to create a future more adaptive, rewarding, and beneficial than our past.

(Insert the ISHMEL Summary about story and memory)

The most salient of our memories are imbued with sensations and feelings, whether good or bad, joyful or sad, angry or content. It is, in fact, the emotional impact associated with a memory that is largely responsible for initiating and strengthening learning.

Indeed, what we call learning is actually a process of importing the patterns, affects, behaviors, perceptions, and constructs recorded from previous experiences (i.e., “memory engrams” 1) to meet the demands of current encounters.

In contrast to “ordinary” memories (both good and bad), which are mutable and dynamically changing over time, traumatic memories are fixed and static. “The past is never dead. It’s not even past.” Rather, it lives as a panoply of manifold fears, phobias, physical symptoms, and illnesses.

These jumbled fragments cannot be remembered in the narrative sense per se, but are perpetually being “replayed” and re-experienced as unbidden and incoherent intrusions or physical symptoms. The more we try to rid ourselves of these “flashbacks,” the more they haunt, torment, and strangle our life force, seriously restricting our capacity to live in the here and now.

Traumatic memories may also take the form of unconscious “acting-out” behaviors. These include, for example, repeatedly having “accidents” or unwittingly exposing oneself to dangerous situations.

A couple of cases in point are the prostitute who, molested as a child, now seeks liaisons with violent men or has unprotected sex; or the war vet, “addicted” to thrill and danger, who applies for the police SWAT team immediately after discharge from the military. “Relived” traumatic memories erupt involuntarily as raw tatters of experience, suddenly imposing themselves on the vulnerable sufferer.

Traumatized people have their lives arrested until they are somehow able to process these intrusions, assimilate them, and then finally form coherent narratives that help put these memories to rest; or said another way, to come to peace with their memories. This completion restores continuity between past and future, and prompts a motivating perseverance and a realistic optimism and forward movement in life.

Painful memories shape our lives in ways we might not ever suspect. How might we work with rather than against them, accessing and utilizing their “compressed energy” to liberate us from their stranglehold?

2 THE FABRIC OF MEMORY

Broadly speaking, there are two types of memory: those that are explicit and those that are implicit, the former being conscious and the latter relatively unconscious.

Explicit Memory: Declarative and Episodic

Declarative memories are the most familiar subtype of explicit memory. The general role of declarative memories is to communicate discrete pieces of information to other individuals. These “semantic” memories are objective and devoid of feelings and emotions. Declarative memories are relatively orderly, neat, and tidy, like the highly structured cerebral cortex that they use for their hardware and operating system.

Episodic memories are often infused with feeling tones and vitality, whether of positive or negative valence, and richly encode our personal life experiences. They form a dynamic interface between the “rational” (explicit/ declarative) and “irrational” (implicit/ emotional) realms. Episodic memory (sometimes called autobiographical), rather than being called up deliberately, emerges somewhat spontaneously as representative vignettes from our lives.

Episodic memories can play an important role in creating positive futures. With each subsequent recollection, the memory becomes enriched, making it ever more meaningful. This natural updating is how memories are meant to operate and how they exert their enlivening functions, often just under the threshold of conscious awareness. Episodic memory turns out to have widespread evolutionary taproots.

It is generally believed that our earliest episodic memories extend back to the age of three-and-a-half, when the hippocampus becomes significantly functional.

Implicit Memory: Emotional and Procedural

Differing radically from both the “cold” declarative and the “warm” episodic memories, implicit memories are “hot” and powerfully compelling. They arise as a collage of sensations, emotions, and behaviors. Implicit memories appear and disappear surreptitiously, usually far outside the bounds of our conscious awareness. They are primarily organized around emotions and/ or skills, or “procedures”—things that the body does automatically (sometimes called “action patterns”).

“Mammal-universal” emotions include surprise, fear, anger, disgust, sadness, and joy. The function of emotional memory is to flag and encode important experiences for immediate and potent reference later on. Like bookmarks, emotions are charged signals that select a particular procedural memory out of a book of possible motor memories.

Emotional memories are generally triggered by features of a present situation in which there are similar types and intensities of emotions. These emotions had, in the past, evoked procedural memories, i.e. survival-based actions (fixed action patterns).

While such action responses are often successful strategies, in the case of trauma, they were decidedly and tragically unsuccessful. Such maladaptive, habitual reactions leave the individual entangled in unresolved emotional angst, disembodiment, and confusion.

Socially based emotions serve two primary purposes: The first is to signal to others what we are feeling and needing, and the second is to signal to ourselves what we are feeling and needing. The central role of social emotions is to facilitate our relationship to ourselves and to others. It is also the way we cooperate and how we convey social norms.

3 PROCEDURAL MEMORY

Procedural memories can be divided into three broad categories.

The first involves learned motor actions. skills like dancing, skiing, bike riding, and lovemaking.

A second category of procedural memory has to do with hardwired emergency responses that call upon our basic survival. These fixed action patterns include bracing, contracting, retracting, fighting, fleeing, and freezing.

The third category of procedural memories is the fundamental organismic response tendencies of approach or avoidance, of attraction or repulsion. The motor acts of stiffening, retracting, and contracting or mechanisms of expanding, extending, and reaching.

The capacity to move between implicit and explicit memory, from less conscious to more conscious (and vice-versa), is also an important theme in integrating traumatic experiences and in generally learning about who we were, who we are, and who we are becoming.

It is the fluid relationship between sensation, feeling, image, and action that is the manifest power of implicit memories in registering emotionally nuanced, relational experiences and continuously computing meanings throughout the developmental arc of our life.

These implicit memories are generally activated below the radar of our conscious awareness, often when we least expect or desire them to show up.

When we see a face, many of us might naively assume that we first analyze it in our mind and then, based on our conscious observations, think and assess whether this person might be friendly or unfriendly—and then respond appropriately.


4 EMOTIONS, PROCEDURAL MEMORIES, AND THE STRUCTURE OF TRAUMA

The critically important subcategory of implicit memories, called procedural memories, involves movement patterns.
These action programs include:
1) learned motor skills
2) valences of approach/ avoidance
3) survival reactions.
The latter two engage innate movement programs (action patterns), which are charged by evolution to carry out actions that are necessary for our survival and well-being.

Let us first consider an example of a procedural memory as an acquired motor skill. Learning to ride a bicycle: We do this procedurally, without any explicit knowledge of the physics or math involved. We learn to master these forces largely by trial and error; the requisite learning curve is, of necessity, quite steep.

Indeed, persistent maladaptive procedural and emotional memories form the core mechanism that underlies all traumas, as well as many problematic social and relationship issues.

A specific example of the persistence of maladaptive procedural memories (involving approach/ avoidance and survival reactions) is manifested in Ana, who was raped as a child by her grandfather and now as an adult stiffens, retracts, and finally collapses in fear and revulsion when caressed by her loving husband.

Ana’s trauma—whether consciously remembered or not—compels the unfortunate mistake of perceiving a threat of violation by her husband.

This resides as a procedural memory, devoid of content, yet playing out as if she were in the clutches of her grandfather. Sensing more deeply how her body stiffens and contracts gives rise to a spontaneous image of the grandfather and the smell of his cigarette-laden breath. Ana then experiences an urge to push him off.

Upon focusing on that impulse, she feels a tentative power in her arms along with the self-compassionate realization that she couldn’t have pushed him off as a child. She then feels a surge of anger and a sustained strength as she pushes (the image of) him away.

Ana then feels a wave of nausea as her forehead breaks out in beads of sweat. This autonomic reaction satisfies and completes the drive to repel her grandfather; it is an important part of the reworking of the original thwarted response to the procedural memory of trying to get away from him. This autonomic reaction is followed by a full deep breath, a spreading warmth in her hands, and then an unexpected calm. Ana notes with gratitude that she is now looking forward to returning home.

Sometimes, low to moderate levels of anger alert us when something is interfering with a relationship or a task. Then, hopefully, that anger guides, motivates, and empowers us to remove the obstacle, thus restoring the relationship and moving forward. At moderate levels, emotions may signal the possibility of danger.

We convey this potentiality to others through body language, via our postures and facial expressions. As social animals, when sensing danger in the environment, we stiffen in readiness, preparing ourselves for action while alerting others, and then can cooperatively take protective, evasive, defensive, or aggressive action.

Intense levels of fear, anger, terror, or rage compel us to instantaneously and unequivocally act with full-out power in action by unconsciously selecting and evoking specific procedural memories for fighting or fleeing. If we cannot fully execute these actions or are overwhelmed, we freeze or collapse in helpless immobility, conserving our energy until safety is restored.

In summary, when high levels of activation surge forth and intense emotions take over, they can “flip” us into the procedural survival programs of “kill or be killed” (fight-or-flight) mode, or de-enervate us into collapse, shame, defeat, and helplessness.

False-Positive Bias
We have evolved a strong false positive bias. We are quick to startle. The cost of a false positive fear is just a few heart beats, and calories. Vs the false-negatives—acting as though something is not dangerous when in fact it actually is—can be fatal and are evolutionarily unsustainable.

Hence, it is better that any uncertainty or ambiguity is experienced as a threat (i.e., that we have a strong innate bias toward false-positives) and then later, after the initial startle, correctly identified as safe; nothing gained, nothing lost.

Our abrupt and escalating emotions of startle and fear instruct us to immediately take heed. However, when these intense emotions and their attendant motor responses (procedural memories) become chronic, the very emotions that are intended to serve, guide, protect, and defend us can become corrosive and turn against us—against the Self.

Renegotiation

Renegotiation is not about simply reliving a traumatic experience. It is, rather, the gradual and titrated revisiting of various sensory-motor elements comprising a particular trauma engram.

Renegotiation occurs primarily by accessing procedural memories associated with the two dysregulated states of the autonomic nervous system (ANS)—hyperarousal/ overwhelm or hypoarousal/ shutdown and helplessness—and then restoring and completing the associated active responses.

As this process progresses, the client moves from hypo-or hyperarousal, toward equilibrium, relaxed alertness, and a here-and-now orientation.

abrupt shift into fear, rage, terror, and horror. The sequence of evoked motor patterns and their associated emotions is as follows:

1.Arrest and alert—associated with curiosity.
2. Stiffen and orient—associated with focused attention, interest, and preparedness. 3. Assess—associated with intense interest, friendliness, or repulsion. This assessment is informed by our genetic memory banks, as well as our personal histories.
4. Approach or avoid—associated with pleasure and displeasure.
5. Fight-or-flight—experienced as fear.

When these active responses are thwarted we:

6. Freeze, as in “scared stiff”—associated with terror.
7. “Fold” and collapse—associated with helpless/ hopeless horror.

Our bodies and spirit collapse while our metabolic processes (including digestion, respiration, circulation, and energy production) shut down. This state of shutdown is mediated by the so-called primitive (unmyelinated) branch of the parasympathetic nervous system via the vagus (tenth cranial) nerve.

In this state, with both the accelerator and brake fully engaged, the autonomic dynamics are such that we may flip back and forth almost instantaneously between sympathetic and parasympathetic (vagal) dominance (hyper-and hypoarousal).

When people become “stuck” in this unstable, paroxysmal phase, they are left in the sheer hell realm of trauma, paralyzed with terror, while experiencing eruptions of blind rage yet devoid of the sustained energy to act. To renegotiate a trauma, the defense-orienting sequence must be reversed by first attending to the completion of the relevant procedural memories of Phases 5, 6, and 7.

We do this by resolving these highly activated states and restoring a more active response where there has been shutdown. In doing this, we successively move back up the chain: from 7 to 6 to 5 to 4 to 3 to 2 to 1.8 In this sequential renegotiation, the individual will return to a here-and-now orientation, with a deepened regulation and inner balance. This completion is evidenced by a restoration of the ANS into its range of dynamic equilibrium and relaxed alertness.

The SIBAM Model incorporates the neurophysiologic, somatic, sensory, behavioral, and affective aspects of an individual’s experience, whether traumatic or triumphant. In a nontraumatized state, the elements of SIBAM (sensation, image, behavior, affect, and meaning) form a fluid, continuous, and coherent response that is appropriate to the present situation.

(Insert the Summary of The concept of SIBAM, and its utilization in renegotiating trauma, is described in detail in of my book In an Unspoken Voice. )

Sensation
physical sensations that arise from within the body, including (from most conscious to least conscious):
• Kinesthetic—muscle tension patterns
• Proprioceptive—awareness of our position in space
• Vestibular—acceleration and deceleration
• Visceral—sensations from the viscera (guts, heart, and lungs) and blood vessels

(Insert Mechano Receptors-(p-dtra/ NKT summary/ ART)

Image
Image refers to the external sense impressions, which include sight, taste, smell, hearing, and touch (the tactile sense).

(Insert the cranial nerves summary)

Behavior

Behavior is the only channel that the therapist is able to observe directly. The therapist can infer a client’s inner states from reading his or her body’s language. These include:

• Voluntary gestures
• Emotional/ facial expressions
• Posture—the platforms from which intrinsic movement is initiated; typically refers to the spine.
• Autonomic signals—includes the cardiovascular and respiratory systems. The pulse rate can be measured by the client’s carotid artery in the neck.
• Visceral behavior—digestive shifts can be “observed” via changing sounds in the gut.
• Archetypal behaviors—include involuntary gestures or postural shifts that convey a universal meaning.

(Insert BioFeedback Summary)

Affect

Affect refers to the categorical emotions of fear, anger, sadness, joy, and disgust, as well as contours of feelings. Contours are the nuanced, sensation-based (felt sense) feelings of attraction and avoidance, of “goodness” and “badness,” that guide us throughout our lives. They are the rudders and bearings that take us through the day.

(Insert the summary about Somatic-Psycho-Therapy Summary)

Meaning
Meanings are the labels we attach to the totality of experience from the combined elements of S, I, B, and A. These include trauma-based fixed beliefs. The therapist helps the client to freely access the full spectrum of developing sensations and feelings to form new meanings, allowing the old cognitive beliefs of “badness” to transform as part of the process of renegotiation.

(Insert the summary about NLP Therapy)

Working in a phased sequence of renegotiation continually strengthens the critical observer function. This is the capacity to stay present and track the various troubling sensations, emotions, and images—to meet them without being overwhelmed. This function, in turn, facilitates coming to peace with one’s memory amalgams.

Traumatized individuals are stuck in chronic contraction; in this state of fixity, it seems to them like nothing will ever change. This no-exit fixation entraps the traumatized individual with feelings of extreme helplessness, hopelessness, and despair. Indeed, the sensations of contraction seem so horrible and so endless, with no apparent relief in sight, that individuals will do almost anything to avoid feeling their bodies. The body has become the enemy.

These sensations are perceived as the feared harbinger of the entire trauma reasserting itself. However, it is just this avoidance that keeps people frozen, “stuck” in their trauma. With gentle guidance, they can discover that when these sensations are “touched into,” just for a few moments, they can survive the experience—they learn that they won’t be annihilated. While exiting numbness and shutdown often feels more acutely disturbing at first, with gentle yet firm support people can suspend their resistance and open to a tentative curiosity.

Then as these sensations are contacted, momentarily and very gradually, the contraction opens to expansion and then moves naturally back to contraction. This time, however, the contraction feels less stuck, less ominous, and then leads to another spontaneous experience of quiet expansion.

With each cycle—contraction, expansion, contraction, expansion—the person begins to experience an inner sensation of flow and a growing sense of allowance for relaxation. With this sense of inner movement, freedom, and flow, they gradually ease out of trauma’s terrifying and gripping “dragnet.”

(Insert the TRE Link Summary HERE)

To summarize, the basic steps in renegotiating a traumatic memory generally involve these processes:
1. Help create a here-and-now experience of relative calm presence, power, and grounding. In this state the client is taught how to visit his positive body sensations, as well as his difficult, traumatically based sensations.
2. Using this calm, embodied platform, the client is directed to gradually shift back and forth between the positive, grounded sensations and the more difficult ones.
3. Through this sensate tracking, the traumatic procedural memory emerges in its traumatic, truncated (i.e., thwarted) form. The therapist continues to check that the client is not in an over-activated (or under-activated) state. If they are, the therapist returns to the first two steps.
4. Having accessed the truncated form of the procedural memory, the therapist, recognizing the “snapshot” of the failed (i.e., incomplete) response, encourages further sensate exploration and development of this protective action through to its intended and meaningful completion.
5. This leads to a resetting of the core regulatory system, restoring balance, equilibrium, and relaxed alertness. 20 (See Figure 7.1, here.)
6. Finally, the procedural memories are linked with the emotional, episodic, and narrative functions of memory. This allows the memory to take its rightful place where it belongs—in the past.

The world breaks everyone and afterward many are strong in the broken places.
—ERNEST HEMINGWAY

Any therapist that is worth his or her fees understands their primarily role is not to counsel, cure or fix their clients, but rather to support the innate capacity for Resilience and Perseverance.