If we are to solve the multiple crises facing human service delivery system – and humanity for that matter - we need a different way of understanding human nature and human dysfunction, but one that incorporates one hundred and fifty years of accumulated scientific knowledge and clinical wisdom. To understand what we are going to “diagnose” and “prescribe” for our troubled social service and mental health organizations, you will need to have a working knowledge about the psychobiology of trauma and adversity, what it does to individuals, particularly when trauma is repetitive, occurs in early development, and is a result of interpersonal violence.
Computers are modeled on the brain and every computer runs on an “operating system” and all the software applications must be compatible with that operating system. We believe that attachment is the Human Operating System, the master program that allows other human functions to work. Trauma disrupts attachment and like a computer virus, wrecks havoc in unpredictable ways, with the total life experience of the person involved. The younger the person is, the more powerful the disruption to this Human Operating System.
Exposure to violence damages the mind as well as the body. The symptoms of post-traumatic stress disorder encompass three major blocks of symptoms: 1) intrusive recollections of traumatic events (i.e. flashbacks and nightmares); 2) the persistent avoidance of anything that reminds the victim of the traumatic event often presenting as a general numbing of responsiveness; and 3) persistent symptoms of increased physiological hyperarousal (startle response, hypervigilance, irritability/fear). But how do we understand this dramatic and often prolonged response to overwhelming stress?
To understand what happens after a traumatic event we must begin with the “fight-or-flight” response that characterizes the way human beings and other mammals respond to overwhelming stress. The ability of the brain to process information in this state changes dramatically from its normal state, just as the body’s response is remarkable and dramatic. The brain is profoundly affected by the powerful neurochemicals that flood the body as a part of the normal stress response. In this state, the ability to encode experience in words often becomes compromised and instead, stress is experienced as strong emotional reactions, body sensations, and images. In such a state, the person is geared toward action, not thought and in fact, there is a decreased ability to think clearly.
One of the important consequences of the stress response is that people lose their “volume control” – they lose the ability to regulate their response based on the stimulus. As a result they become unable to calm down and stay startled, frightened, impulsive and irritable long after the immediate danger has passed. In situations of family violence, this loss of “volume control” can be chronic so that the person comes to believe that this state of arousal represents their normal “self”. In such a circumstance, it becomes easy to understand why people might turn to alcohol and drugs – prescription and nonprescription - as a way of self-medicating themselves.
Another normal response to abnormal stress is “dissociation”. Dissociation is defined as a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. Since emotions can, in fact, kill us, dissociation is a protective brain response to overwhelming arousal. When terror becomes life-threatening, the brain can separate thought from feeling and thought and feelings can be separated from memory. As a result, victims of violence often develop emotional numbing, the inability to experience certain emotional states, and amnesia for the traumatic events. When this happens, they are more likely to reenact the traumatic event in a wide variety of disguised ways.
Chronic Maladaptive Pathways as a Result of Toxic Stress Exposure
The ways in which each individual copes with exposure to trauma, adversity and toxic stress varies and is determined by multiple factors in the person’s lifespace. This chart shows the worst case pathways.