Trauma and Violence do Damage but Healing is Possible

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by John Rich | posted in ,
12/16/2009

For the past few weeks, I have been scanning the news for emerging research about violence and trauma. In the process, I keep running across the following report of a study done at Stanford University - http://www.mercurynews.com/breaking-news/ci_14007056?nclick_check=1 . Dr. Victor Carrion and his fellow researchers looked at children who had symptoms of posttraumatic stress disorder using a technique called functional MRI. This technique seemed to show that compared to children without posttraumatic stress, the affected children had less activity in an area of the brain called the hippocampus. This is important because the hippocampus is involved in learning. The conclusion of the study is that children who have suffered trauma and who have PTSD may not learn as well as other children. They also found that the more severe the childrens’ symptoms of avoidance and numbing, the lower their level of activity in the hippocampus.

So, is it news that children who are exposed to trauma have more trouble learning? Probably not. But this is just another in a long series of studies that show that early childhood adversity and trauma are harmful to children in very specific ways.

From my perspective, these studies can be helpful on one hand and terribly destructive on another. If we conclude from these studies that in order to help kids learn we should work to protect children from trauma, nurture them in schools, make sure they grow up in safe neighborhoods and train their parents how to raise them most effectively, then these kinds of studies can build momentum for us to do what we should do. Unfortunately some will take these results and run with them and come to the conclusion that poor urban children of color should be carried off to the garbage heap as damaged and dangerous little people. You think I exaggerate? Well think again, because I've heard these kinds of comments more times than I care to recall.

Fortunately there is good evidence that the damaging effects of chronic stress and trauma can be healed. In the New York Times several months ago - http://www.nytimes.com/2009/08/18/science/18angier.html?_r=1&scp=13&sq=mcewen&st=cse  -  neuroscientist Bruce McEwen makes the point very well. He says “The brain is a very resilient and plastic organ. Dendrites and synapses retract and reform, and reversible remodeling can occur throughout life.” He should know since he has been a leader for years on the effects of chronic stress on the body.

My own experience as a physician, and my work with young people who have been victimized tells me the same thing: the brain can heal. But we have to fight to create the kinds of nurturing environments that allow it to do so.

More to come.

 

Comments
By Sandy Bloom at 2009/12/17 09:48

As Dr. Rich points out, there is little question left that exposure to toxic stress and adversity can damage children's development in a variety of ways. As scientific knowledge grows, there always exists the possibility that science will be used to destructive ends. And yet without advancements in scientific knowledge we remain ignorant, stumbling in the dark to find solutions to very complex problems. Knowing that the brains of children who are exposed to disrupted attachment, violence, and overwhelming stress can be damaged should urge us toward better prevention, to address the basic social issues allow so many children to sustain this kind of damage. At the same time, after decades spent treating adults who have sustained these kinds of injuries in childhood, I know that healing is possible. Children, adolescents, and adults who sustain psychological injuries can be helped to heal and change the trajectories of their lives. But helping their brain, bodies, minds and spirits to heal requires well-educated, trauma-informed, innovative helpers and a community that supports the work of healing.

Research on Healing
By Ramon P. Llamas at 2009/12/19 09:56

This is a very interesting topic and I'm glad I stumbled upon it from the home page...Just reading all three posts, in reverse chronological order, a few research questions come to mind:

*how much trauma causes neurological restructuring?
*how long does the brain take to heal from stress-induced restructuring?
*what factors support healing (measured through functional MRI) - ex: pets, social support, childhood comforts (baby blanket, pictures, etc)?

Answers to these questions would provide policymakers with evidence to justify further investigation and inclusion of reimbursements to treat individuals living with PTSD among other emotional disorders. Additionally, since legislators' must reach the bottom line financially, the argument can be made for increased productivity backed by evidence, as basic research is translated and implemented into practical settings.

Thank you for raising awareness on this topic!

Damaged Hippocampus
By Sara at 2010/01/06 09:06

Curious! Thank you for your post.

You didn't, however, mention anything about the trauma actually causing the hippocampus to shrink. I've recently read some research that has shown the size of chronically depressed/complex ptsd/anxiety sufferers' hippocampus to be much smaller than a healthy one. It has been said that it will continue to shrink without help but that certain measures like taking antidepressants might help to keep it from getting smaller. I've found no research that implies that the hippocampus might actually grow larger as it heals itself. Is this possible?

Lastly, nothing heals like personal relationships, yes? So how does one get someone who is highly triggered by people to "trust" people or even want to be around them? Often times this means meeting new people because family or previous relationships have been destructive. Hospital settings tend to cause more relational damage.

The Brain and Trauma
By John at 2010/01/08 08:00

Great insights/questions from both Ramon and Sara. The developing neuroscience of trauma and stress is fascinating but complex. Bruce McEwen has written about this - I will his article under "Resources" - and he finds that while chronic stress can change the brain, especially the hippocampus, exercise and social support can repair some of the damage.

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