Dr van der Kolk from 2014 NICABM series

Flashbacks: When people start reliving their trauma, much of their brain goes offline. They immediately get pulled back into the past. Their emotional brain on the right goes back there, sees the images of what happened back then, and experiences physical sensations. Stress hormones get released and the body starts behaving again as if the trauma is happening right now. The timekeeping part of the brain that tells you, that was then and this is now, tends to go offline. When you really go into the most elementary, fear-driven situation, you cannot talk.

We help people to integrate the story and it becomes a memory of the past. We do this by focusing on being very present in the here and now at any moment. You do that with breathing, tapping, eye contact, feeling your body – keeping your interoception aligned.

A big job of being a therapist for traumatized people is to be an affect regulator who keeps their body safe and makes it safe for the mind to visit the past without getting hijacked by it.

How trauma hijacks the brain

The amygdala, the part of the primitive brain area that makes you afraid, becomes hyperactive. How do you rewire it? We don’t completely know that yet. We do know you cannot change irrational, organic responses from your body, except by becoming deeply involved in your self – noticing your internal world.

The thalamus receives sensory input and, when in a very high state of arousal, breaks down into unintegrated images, sensations, thoughts, smells and sounds of the trauma. Trauma is about sounds and images that make you flash back. This happens because the thalamus can’t do its job. How to calm the thalamus? Neurofeedback helps. EMDR is being studied now for this and initial research backs up it’s effectiveness.

The medial prefrontal self-experience part of the brain determines how reactive you are to your environment. The more trauma you have, the more reactive you are. The good news is the neuroplasticity of the brain. The more you experience your internal world, the more you build up and activate this part of your brain safely, you then experience less reactivity.

Yoga, meditation and mindfulness help. You see things happen and do not automatically react to them. You learn to be still, to notice your self, and to tolerate your sensations.