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Improved and New Blog - It's a brain thing

From: Post Traumatic Stress: It’s a brain thing

Have your ever seen a war veteran jump when he hears a loud sound? Or seen a movie in which a character is troubled with vivid flashbacks of a terrible event that happened to him? These symptoms may be due to Post Traumatic Stress Disorder. PTSD is a psychological disorder in which sufferers have trouble coping with their traumatic pasts. Symptoms of PTSD include nightmares, flashbacks, skittishness, and intense physical and emotional reactions to stimuli associated with their traumatic memories. People most likely to get post traumatic stress disorder are war veterans and victims of physical and sexual abuse (Stress). Psychologists are conducting some innovative studies that examine the brain activity of PTSD patients during both the recall of a traumatic event and during therapy. The findings from these studies may lead to groundbreaking discoveries of how the human brain functions.

Psychiatrists Israel Liberzon, Jennifer Britton, and K. Luan Phan did a study involving veterans with PTSD at the University of Michigan’s Veteran’s Affairs Medical center. The subjects of the study were sixteen combat veterans suffering from post traumatic stress, fifteen combat veterans without PTSD, and fifteen “age-matched, healthy control subjects” (Liberzon et al). These psychiatrists were interested in observing what happens in the brains of PTSD sufferers when re-experiencing a traumatic event. They also wanted to compare this brain activity to subjects without the disorder to discover what activity is unique to post traumatic stress. The researchers used positron emission tomography (PET) to monitor the activity in the brain by utilizing “radionuclide-labeled tracer molecules to measure changes in regional cerebral blood flow” (Liberzon et al). They conducted these PET scans while inducing a traumatic experience. The psychiatrists had the subjects look at a set of images while actors read a script to recreate stressful, combat related events. The combat subjects wrote and personalized the scripts themselves, so the readings evoked personal memories. The researchers labeled the combination of the images and the script reading as “symptom provocation paradigms” (Liberzon et al).

The results of the study are quite interesting and informative. The subjects with post traumatic stress disorder showed an operation dysfunction in the limbic system and the surrounding paralimbic regions (Liberzon et al). The brain’s limbic system is the control center for emotions. It is made up of several small parts including the amygdala, and pituitary gland. The amygdala is responsible for fear and aggression and the pituitary gland regulates several hormones such as adrenaline. The limbic system is the reason we are able to experience and control our emotions. Since the PTSD patients have altered activity in this brain region, they may have a harder time coping with their feelings, especially feelings of fear (Liberzon et al). The psychiatrists observed increased and different blood flow in the amygdala and insula of PTSD subjects.

They also saw decreased or altered flow in the medial prefrontal and anterior cingulate cortex which, according to their report, is a neural circuit responsible for the emotional processing and regulation. PTSD sufferers and combat controls showed different blood flow patterns in these brain regions, so the difference in activity was not simply due to their exposure to combat (Liberzon et al). The PTSD patients are literally and physically processing their memories differently from people who experienced similar situations but do not have PTSD. Liberzon, Britton, and Phan came to the conclusion that this difference in neural processing may be responsible for the “deficits in emotional processing in PTSD” and “resilience to trauma” in the combat subjects without PTSD (Liberzon et al).

Psychologists are also learning new things about PTSD therapy. Sheldon Lewis of Advances in Mind—Body Medicine journal held an interview with psychotherapist, Dr. Belleruth Naparstck who developed a therapy method called guided imagery. The therapy attempts to equip PTSD patients with mental tools for coping with their emotions (Lewis). Guided imagery makes use of the patient’s imagination and sensory recall to deal with emotional stress. In guided imagery therapy, the patient looks at a series of pictures and/or listens to audio commentary that directs the patient towards using healthy mechanisms to process and resolve their unsettling emotions (Lewis).

Some common images used are from spiritual and healing traditions such as golden light and the presence of a companion. Dr. Naparstck’s therapy has been especially successful. Her audio programs are used by over 1,500 hospitals around the country and her books and programs are distributed by several groups working with trauma patients such as the Veteran’s Administration, the Red Cross, and Oklahoma City Disaster Services (Lewis).

According to Dr. Naparstck, many psychologists think that “talking through” the memories that haunt PTSD patients is an ineffective method of therapy. Naparstck says that PTSD sufferers cannot “just talk through their issues with you.” PET scans have shown that PTSD patients have significantly smaller language centers in their brains which may contribute to the difficulty they have in processing memories and emotion. Talking about these memories flips a switch in their brain to induce a flashback which Naparstck defines as “not a real memory—it’s a form of reexperiencing the trauma with vivid, unprocessed, sensory fragments, perceptions, emotions, and kinetic reactions. So you’re basically re-traumatizing people in your office and they’re paying for it” (Lewis).

Naparstck wanted to create a therapy method that actually helped patients instead of abusing them and apparently her programs are working. Studies have shown that this is a satisfactory way to treat posttraumatic stress. Patients at the VA Gulf Coast, in Biloxi, Mississippi, reported that, though some of them found the imagery uncomfortable, they all said that they would do it again. Many continued to use the therapy even after the study was over and they said they would recommend it to their buddies (Lewis). Dr. Naparstck said, “We would stumble on remedies and help people heal in spite of ourselves, but our track record was shockingly lame. However, now we do know, or at least we know enough…..These are exciting times to be in this field” (Lewis). I could not agree with her more. The studies conducted by Liberzon et al, and Naparstck are very encouraging. Science is on the road to being able to help people who suffer from post traumatic stress.

PET scanning has revealed that PTSD patients lack the necessary neural circuitry to process and cope with their emotions. Thanks to imaging technologies that allow researchers to be able to scan the brains of their subjects, we are learning more and more about how the human brain works and malfunctions.

Knowing more about these problems will help psychologists be able to solve them in the future. Works Cited Lewis, Sheldon.

Entering Our Broken Hearts.” Advances in Mind--Body Medicine 21.1 (2005) : 29-32. Liberzon, Isreal, Jennifer Britton, K. Luan Phan.

Neural Correlatos of Traumatic Recall in Posttraumatic Stress Disorder." Stress: The International Journal on the Biology of Stress. 6.3 (2003) : 151-156.