PLOS ONE: Aberrant Functional Connectivity of the Amygdala Complexes in PTSD during Conscious and Subconscious Processing of Trauma-Related Stimuli
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0163097
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There is something we can do. Staying home is active not passive. Please stay home!
Coronavirus: The Hammer and the Dance
buff.ly
What the Next 18 Months Can Look Like, if Leaders Buy Us TimeThese are challenging times indeed. I just want to take a moment for all of us, trauma therapists and trauma patients together to breathe and to quiet the arousal that inevitably arises under the threat posed by the virus.
Let me first speak to those of you who are dealing with the aftermath of histories of devastating childhoods. You know that your fear systems are going to go into high alert. This is the way this goes in your brain. Not your fault. Not a flaw in your character. It is the “isness” of developmental trauma. You may even experience a return or heightening of symptoms. Don’t be discouraged. It’s your amygdala trying to activate you for what it “thinks” is for your survival. It is not to be believed! If there is an inner child, it’s your amygdala and it needs your best adult guidance. You know these patterns in yourself. You need to eat wisely, sleep well, exercise, stay in touch with good people, avoid alarming TV or anything alarming, monitor your news intake, in short do everything you can to enhance your immune system. This is the worst time to engage in risky behaviors of any kind, even when the pressure builds up to do so. I do understand what people with developmental trauma endure. I know how rough it is. Please be gentle with yourself and with all those around you and even if it’s the first time ever, practice self care. And know that although you can feel so dreadfully alone, you’re not. There are millions of us.
Everything I’m reading suggests that early action is the best action to slow the spread of the virus. As a trauma therapist you are likely feeling a lot of mixed feelings and opposing instincts. We are in this field to help people who suffer terribly and of course these are times that will inflame the terror and disregulation our patients already try so desperately to manage. They will need you. But you yourselves must stay well to help them. Take every precaution -those that are becoming part of our daily litany- and do as many of your therapy sessions as possible while observing social distancing. It hurts to even write much less to do it.
For those of you doing neurofeedback- which I certainly hope is most of you- you can’t do NF and observe social distance. Let your patients know that if they’ve been training for awhile, their brains will remember. Even if regulating effects don’t completely hold, their brains remember. They won’t lose what they know. It will return. For many it can be helpful to visualize the screen and recall the beeps when they feel the stress rising. As a colleague of mine once said, “The brain is devoted to its own regulation. It has to be.” If they are new, their brains could slip back into old patterns. Help them remember during the break that their brains were able to train, that the problem is this glitch in their brains and that you will both be back on this as soon as it is safe to do so.
Those of you who own your own systems can bring them home too. Train regularly. Lowering stress reduces inflammation and will enhance your immune system. This will help you and everyone around you!
Please stay healthy and stay sane. The world needs every one of us to do this well.
Blessings,
Sebern
The following is the final part in the five-part Story of Cybele, a woman I worked with who was suffering from Dissociative Identity Disorder. This case study was first published in my book, Neurofeedback in the Treatment of Developmental Trauma: Calming the Fear-Driven Brain. You can find it in Chapter 9 along with two other fascinating and I think compelling case studies showing the potential benefits of neurofeedback for those who have suffered severe neglect and assault in childhood. For more, join my new webinar “The Nature of Forgetting” – information is available at www.trainingtrauma.org.
This part includes sessions 64-90.
• Session 64 (alpha–theta: 24). Woke up this AM. desperately wanting to be stable. Asks for alpha–theta. She’s been sick with flu for 3 weeks; not taking very good care of herself. Seems depressed and also realistically overwhelmed by memories of trauma. A little bit of a dazed, hunched girl today, pale and sad. “This feels terrible, but it is 10 times better than it used to be. In the past, this would have been one of my good days.” After training, feels less sick and calmer.
• Session 65 (alpha–theta: 25). Slept 11 hours and then had to be woken. Still feels pretty bad physically but better emotionally. Looks better; more color. Mood is improved. Asked her to visualize being well during alpha–theta. Couldn’t stay with it because she needed to blow her nose. With eyes-open training she quiets and gets tired.
• Session 66 (alpha–theta: 26). Came out after a restless 10 minutes. “Terror . . . too many crossovers.” When beginning eyes-open training, however, she says, “I am distant and calm.” She told me of an episode with scissors and says that she now has a glimpse of “why I became the way I was.” I note her use of the past tense, but don’t share it. Pushed slow wave down at the end of the session; she could feel it in her stomach. As she was ending, she said, thoughtfully, “I love the details of people’s lives. I love people. I even love the human condition.” After a pause she added, “I may be doing neurofeedback too young. Who will I marry?”
• Session 67. Now on antibiotics. Worn out from being sick so long. Denies being depressed; more aware, not always happy, but now unhappy with things around her. “I am now practical.” She is deciding her own protocol, and today it’s not alpha–theta.
• Session 68 (alpha–theta: 27). Assertive, clear, mature, and happy. Able to draw the boundary in sexual relationships. “I know what I want.” I remind her of the date, and she burst out laughing, saying, “Yes, things have been more active, but I wasn’t aware that it was the Equinox. It wasn’t acute. I like how I have changed. I really love being alive.” Many crossovers and a mixed experience. Made the brook (alpha entrainment) return when she wanted it and was proud of this. During eyes-open training she is able to drop delta–theta to 9 µV and reports seeing everything with a crystal clarity she’s never felt before. Sad too, that this is the first time that she’s lived in this reality.
• Session 69 (alpha–theta: 28). Yesterday, Patrick was here. We spent most of the session talking about the realities of integration, her fears, her OK-ness, the sense that things are blending, that she is getting characteristics of her alters and their memories as well. Questions about who she is, what is her identity, and fears of her integration invalidating the reality of the horror of her past. After 5 minutes and many crossovers, she comes out to tell me that she felt “small and big at the same time, bobbing in the air, like seeing the scope of who I will be as all fifty parts come together . . . scary.”
• Session 70 (alpha–theta: 29). No nightmares. Sadness. “My worst problems now are from the stress of my present life.” Neglect issues are surfacing over those of abuse. She is softer and lighter. “No hard edges.”
• Session 71 (alpha–theta: 30). Everyday this girl comes more into herself. She is assertive and kind, thoughtful, funny, and mature. Still some hint of cowering, but only a hint. Teaching herself the penny whistle. “Now that I don’t spend every day trying to survive, I can do these things.” Emotionally articulate and able to discriminate finely—like the difference between being helpless and feeling impatient. Does not want to kill her abusers; just wants them as far away as possible. She is very funny about Angela’s Ashes (McCourt, 1996). Comes out of alpha–theta at 13 minutes, saying she’s done enough, but then decides to finish the 20 minutes. “A sick, nervous feeling.” Feeling good at the end. Focus is on the legacy of neglect.
• Session 72 (alpha–theta: 31). Tired and sad. Not depressed. More like mourning over the state of the world. At 7 minutes comes out because of agitation, but quickly feels better and returns. Left feeling very good, laughing and “smart.”
• Session 73 (alpha–theta: 32). Good shape. Sadness about her own growing ability to connect and the inability of her friends to do so with her. During alpha–theta, many memories arise (none new) of mother’s bizarre behaviors—those that made her realize that she was crazy. Very high delta during session, but low affect. “I know it is not happening now.” A little internally “mad,” almost manicky. Calms down with eyes-open RH training.
• Session 74 (alpha–theta: 33). Mood up and down. Really contending with the sadness of the reality of life. Read a book very quickly. Grasping what she reads more readily. Has to stop alpha–theta: Her brain feels “riled.” She has old impulses. Wants to run. Aroused. Her delta is once again higher than all other bandwidths. She leaves more agitated than I or she would like, but thankfully, she no longer poses a threat to herself.
• Session 75 (alpha–theta: 34). Feels like she’s turned another important corner. Writing is fluid and creative. States of withdrawal have gone. Detachment is gone. More able to pay attention, stay open, and be curious. Lots of new recognition of the reality of what she’s been through.
• Session 76. Cybele reports a traumatic reaction to scene in the movie Practical Magic that reminded her of her mother—a rapid turn from affection to threat and sex. “Like a biological reaction—so extreme I couldn’t shut it off. Not really dissociated.” Seems like an unfamiliar experience. Got very stoned a few nights ago and it didn’t have the same effect. It passed through her system more quickly and she could override its effects. Delta–theta still high (over 20 µV). As she was leaving, she said simply, “I am doing great.”
• Session 77. “I’m not much of a multiple anymore. I need these guys—like threads pulled out of a tapestry, they are being pulled back in.” Feels good on leaving.
\• Session 78. She asked for the same protocol, as she was calmer in general except during “high stress times.” She was knocked out by soccer ball. “Standard PTSD stuff” related to abusive roommate. Bad dreams. Now we have the possible complications of head injury.
• Session 79 (alpha–theta: 35). Some PTSD intrusion around memories of her mother. Troubling, vivid dreams; in some she can fly. She wants to deal with these in alpha–theta. Very high delta amplitude, then theta, then alpha. At times alpha overtakes delta. After the session she reports: “For awhile it felt awful. Mother’s beatings. Felt shuddery. Very high anxiety; then I calmed down . . . afraid, the ‘corner of the eye fear.’” Some concern that she’d have a flashback during alpha–theta, but she didn’t. Feels good after eyes-open training.
• Session 80. Burst of enormous creativity. Five poems in a week. Bad dreams are over but she still wakes up with a startle. “I hate apathy. I wish my friends would dig their hands into life.” She called between sessions to tell me that her friend (and a patient of mine in the residential center) had hung himself.
• Session 81 and 82. We talked together about the boy who hung himself and had our own private memorial for him. In talking today more generally about all that has happened and about her dissociative states, she realizes that one of her male alters, named after her most sadistic abuser, felt like her last resource, like what stood between her and her death. “He wanted me to believe that, and I have.” Suicidal thoughts are up particularly after her friend’s death, but she was able to feel quieter after training.
• Session 85. She is stressed. She can hear “alters’ voices in the background,” but she says, “they are not DID enough to pay any attention to.” They can’t overtake her or take over for her.
• Session 89 (alpha–theta: 36). During alpha–theta training she has memories of a babysitter who was kind to her, even tender and singing to her. She has had very stressful encounters with the men in her life and reports that “all the little ones feel betrayed. The room was spinning. I had to calm them down and they were all in my body. It was physical.” This was to be the last report of alters.
• Session 90: “I am leading a charmed life now.”