Research has unveiled the brain changes and functions that occur when a person experiences the longer-term effects of trauma. Trauma is experienced when the flight or fight reaction is prolonged as the result of a very disturbing or scary occurrence such as a natural disaster, physical assault, or car accident. Below are the main brain structures involved in trauma and how they are affected.

Hippocampus -is deeply embedded in the temporal that regulates the storage and retrieval of memories, as well as differentiating between past and present experiences. During trauma, the nervous system is stuck in high gear, stress hormones remain elevated which damages cells in the hippocampus making it difficult to sustain or recall memories. The hippocampus shrinks causing an inability for the person to tell the difference between past and present experiences. The person cannot tell the difference between the past memory and the present situation. Environments that resemble where the trauma took place can cause panic, fear, and aggression. Since it is unknown to them whether the threat has passed, the person remains hypervigilant- stuck in reactive mode. Hypervigilance causes elevated levels of stress hormones, making it difficult for the body to regulate itself.

The PFC (Prefrontal Cortex), or thinking center, is located near the top of your head, behind your forehead. It’s responsible for abilities including rational thought, problem-solving, personality, planning, empathy, and awareness of ourselves and others. When this area of the brain is strong, we are able to think clearly, make good decisions, and be aware of ourselves and others. The PFC helps suppress negative emotions, as well as plays a role in personal and social decision-making. As a result of trauma,  the PFC loses volume and shrinks affecting the ability to think, plan, and connect with others while heightening fear and other negative emotions.

The ACC (anterior cingulate cortex), or emotion regulation center, is located next to the prefrontal cortex, but is deeper inside the brain. This area is responsible (in part) for regulating emotion, and (ideally) has a close working relationship with the PFC. 

The Amygdala is the threat detector. Its primary job is to receive all incoming information — everything you see, hear, touch, smell, and taste — and answer one question: “Is this a threat?”  As a result of trauma, it increases in size. An overactive amygdala is responsible for negative mood alterations, an extreme startle response, and avoidance of anything related to the trauma. 

In Summary:

  1. The Thinking Center is under-activated.
  2. The Emotion Regulation Center is under-activated.
  3. The Fear Center is overactivated.
  4. The memory system for contextual memory functions improperly

The good news is that these changes can be reversed with psychotherapy often combined with medication. Brain wiring is malleable.