Tag: PTSD

Michele Patterson Ford, Dickinson College

When survivors of trauma recount their experiences, they are often questioned because of how they relay their stories. They may have problems remembering what happened, or their memories may be jumbled or even contradictory. People hearing those stories – attorneys, reporters, healthcare workers or friends – may expect a clearer, linear narrative.

Those unaffected by trauma may also be surprised to hear how the person acted in the moment. It’s easy to assume that someone experiencing a traumatic event would have a “fight or flight” response, instinctively fighting off a perpetrator or fleeing the scene – but that might not be the case.

Understanding the science of how trauma affects memory and behavior reveals why these responses can actually be expected and are not contradictory.

In both my academic and clinical work as a psychologist, I have witnessed the impact trauma has on people’s memories and behaviors, especially when an event in their present life triggers something from their past.

Research shows that taking a trauma-informed approach, which prioritizes understanding and curiosity about someone’s experience as opposed to judgment or critical evaluation, increases empathy for survivors’ thoughts, feelings and behaviors.

How trauma affects the brain

According to the World Health Organization, approximately 70% of people worldwide report experiencing a traumatic event in their lifetime. The majority of these people do not develop PTSD, a clinical diagnosis of symptoms, such as having nightmares and flashbacks about the event, avoiding places that are reminders of it, and increased arousal that can make concentration and sleep difficult. Many survivors don’t meet criteria for PTSD but struggle with feeling distressed, depressed or anxious.

In traumatic situations, people often respond in unexpected ways, and they may second-guess themselves. This may happen particularly when someone experiences a repeated trauma, which is more likely than not due to how many people experience traumatic events.

Trauma also distorts how memories are stored and retrieved.

Research indicates that people experience traumatic memories differently than memories of other significant events, such as sad or positive experiences. Two of the main brain structures scientists believe are involved in storing traumatic memories are the hippocampus – responsible for memory storage – and the amygdala, which is responsible for processing emotions.

During trauma, the amygdala becomes highly active, processing emotions such as fear, and the hippocampus becomes overwhelmed by stress, leading to problems with memory storage.

Traumatic memories do not follow a neat, linear story. Instead, people may experience the memory as disconnected fragments of sensations, emotions, smells or images. Such memories cause the body to reexperience the past threat as if it is happening in the moment. This may cause a person to feel like running away or fighting back – flight or fight. Or they may freeze.

In other words, people don’t have the distant perspective they often feel with other memories from the past. Rather, they may feel they are reliving the original experience.

Misinterpreting victims’ behaviors

With this understanding, consider someone who experiences a trauma at the hands of a professional during an appointment. They may appear outwardly calm while it happens and then leave the session as they typically would – checking out, providing payment and possibly even scheduling the next appointment. While their response to act normally may seem odd, such behavior makes sense for someone trying to escape a threat.

Fight, flight or freeze responses have become widely known in popular culture. In a freeze response, a person’s mind goes blank and they may be unable to speak, leading to a “deer in the headlights” behavior.

On the other hand, a person may act paradoxically – perhaps by going on about their day as if nothing happened. They may not report the event or may question whether the incident even occurred. This represents another survival response – the lesser-known fawn response. This way of handling stress occurs when someone acts calm, appeases the threatening person and retreats to de-escalate the situation. Instead of literally backing away, in this example, the person metaphorically backs away by completing the session and exiting as expected without further conflict.

Outsiders may misconstrue these behaviors as evidence that a trauma did not actually happen or that a survivor lacks credibility. But that logic reflects common misconceptions about how people “should” remember or respond to trauma.

If this was the person’s first experience with a traumatic situation, afterward they are likely to feel afraid, disoriented or hyperalert. However, if they had previous similar experiences, this scenario may trigger past memories in the moment. This can muddy the experience even further, making it difficult to recall the incident later, especially under stressful circumstances.

When a survivor reports an incident and ultimately testifies against someone who harmed them, memory recall might be uniquely affected. Most people in this situation would be highly stressed, especially if the perpetrator were in the room.

To make matters worse, the feeling that the recalled memory is actually happening in the moment and not in the past may cause a survivor to convey a more fragmented story. They may also have either a more intense or detached emotional experience, depending on their own trauma responses.

Legal and other professionals unaware of the range of natural responses to trauma can easily misinterpret these behaviors as signs of lying or malingering.

In reality, the percentage of people who falsely report sexual assault, for example, is low – between 2% and 10%.

Providing better support

Research shows that people who better understand nuances of trauma and mental health in turn are more empathetic toward survivors. Some healthcare settings have adopted a trauma-informed approach to prevent retraumatization and build safety. Studies show that even being attentive to word choice can help ensure effective care for patients that avoids victim blaming.

A trauma-informed approach can also improve legal and justice systems so victims are better supported. This includes understanding why accounts aren’t linear and not equating memory inconsistencies with lying.

Research also shows that trauma-informed responses are equally important in everyday relationships. In friendships and close relationships, or in the workplace, patience and empathy convey a sense of respect, safety and trustworthiness. These offer a strong foundation for positive social and working relationships, which can lower a survivor’s distress and support their healing.

When people have a greater understanding of how trauma affects the brain, they gain insight into how survivors think, act and process their memories. What initially looks confusing or inconsistent is actually behavior that flows logically from a traumatized brain.

Having a trauma-informed perspective helps people to be better friends, co-workers and professionals. By extension, responding from this awareness may even help survivors understand their own reactions and experiences, which may ultimately aid their healing and ability to lead fulfilling lives.

Michele Patterson Ford, Lecturer in Psychology, Dickinson College

This article is republished from The Conversation under a Creative Commons license. Read the original article.