An Extract from The Trauma Recovery Handbook
This is an adapted extract from Section 1, Chapter 1 ‘Understanding Trauma’ of The Trauma Recovery Handbook by Betsy de Thierry.
The basic neuroscience of trauma
A simplified understanding of the neuroscience around terror, powerlessness and overwhelm is important. When people can understand the automatic, primitive, natural reaction to terror, shame is reduced. When we can explain it to children, they can feel empowered to understand themselves and see that recovery is possible. If we know why we act as we do, we feel more able to change, and this is where simplified neuroscience is important. We teach children that they have a brain that can be seen as made up of different parts that all have a purpose. A very simple concept is that we have a back brain, which is the brainstem, where our brain’s automatic, primitive processes occur from birth. This is also the area of the brain that reacts throughout our life with the automatic fight, flight, freeze response to any possible threat. When that is activated, the thinking brain (prefrontal cortex) is no longer ‘working on full power’ because the person is trying to stay alive, and this means they have less ability to reflect, think or be reasonable or rational.
At the same time as our thinking brain is stuck in panic and freeze mode, and our brainstem is making us react automatically, the limbic area of the brain is also stimulated. The amygdala, which is in the middle of each side (hemisphere) of the brain, begins to alert the body to the danger that is perceived or real, and it causes the people around them to be seen as threatening as the person looks for safety. When we understand this basic overview of how the brain automatically reacts to threat, we can see the importance of the sequence of what support we offer.
For example, we cannot try and have a rational conversation when someone is running away from a place of danger, or if they are screaming in pain. We must first wait for them to feel less terrified, so that they can think and reflect. This may take some time! If a child looks shocked or terrified, we cannot ask them questions about what happened until they feel calmer, because they neurobiologically can struggle to remember anything until they feel safer and less terrified.
Although the brain stops growing in size by early adolescence, the teenage years are all about fine-tuning how the brain works. Researchers articulate that ‘it is well established that the brain undergoes a “rewiring” process that is not complete until approximately 25 years of age’ (Arain et al., 2013). The prefrontal cortex, which is responsible for thinking and being reasonable and rational, is one of the last parts of the brain to mature. This area is responsible for skills like planning, prioritizing and making good decisions. Scientists and researchers are continually discovering more about the brain and how it works, and while this is a very simple overview of the most complex organ of our body, it does help children begin to understand themselves as complex and clever, and enables them to feel less powerless.
A trauma-informed approach to trauma recovery
There has been a recent rise in dialogue, training and documentation using the term ‘trauma-informed’, and this book is building on the foundation of a trauma-informed practice but with the focus on facilitating recovery from the trauma. Trauma-informed cultures and organizations recognize and validate the impact that trauma has and seek to create safer environments for those who have experienced trauma to be able to be included and feel cared for. Sadly, some organizations or professionals who use the term trauma-informed to describe their practice have somewhat over-simplified trauma and its impact and have practices that are in conflict with the understanding that when adults use any form of shame or fear to alter behaviour, they are exacerbating the trauma responses.
While there is indeed a celebration of the worldwide spread of the trauma message, which validates many people’s pain and symptoms of turmoil, there is also a degree of frustration at the term being used when the words may clash with the practice of some individuals and organizations. Many professionals who define themselves as trauma recovery specialists are often not equipped to facilitate recovery from complex trauma, and especially not within the area of the subconscious and complex dissociation.
I like to say that there is a difference between doing a trauma informed training course that is like my first-aid course which sits in ‘my back pocket’ as a tool for an emergency that I hope I don’t have to use, and a trauma-informed training which should be like being given a new pair of glasses. The glasses change how you see the world, the humans within it and what we can all do to bring hope, healing and recovery to those around us and to stand up against injustice. It changes our view, approach, culture and systems to be kinder and intentional towards recovery. While all people and organizations could be trauma informed and trauma sensitive, I would argue that without a specific trauma recovery model such as my TRFM®, which is explored in this book, trauma recovery is rarely achievable. Crisis recovery is possible, which is the essential support that is needed when someone first discloses or asks for help because they are in a crisis.
Trauma recovery is different from crisis recovery. Trauma recovery requires more specialized skills that unpick the layers of the impact of trauma that have occurred while the terrifying experiences have been happening and during all the years since, but crisis recovery is vital to offer help in that critical time of help being urgently needed. Without trained professionals offering specialized trauma recovery therapy working alongside trauma-informed practitioners, it is hard to see how the recovery can be fully achieved, especially with complex trauma.
Questions to reflect on
For parents/carers/therapeutic mentors:
- What trauma type would the child you are supporting probably be? Why?
- What are their main trauma symptoms?
- What are their greatest needs right now?
- What do they do when they feel terror?
- What do they do when they feel powerless?
- What do they do when they feel overwhelmed?
For therapists:
- What trauma definition have you been using and why?
What additional preparations do you make for a child who has experienced Type III trauma compared to one who has experienced Type II?
The Trauma Recovery Handbook is available now in paperback or ebook.
Betsy de Thierry is a practising psychotherapist and with over 30 years of experience and knowledge within the field of Complex Trauma & navigating Trauma Recovery. She is the founder of Trauma Recovery Global, which provides training and consultancy and partnerships with select organisations and practitioners to licence her Trauma Recovery Focused Model (TRFM) in 34 nations. She is also the founder of the Trauma Recovery Centre (TRC), a charity specialising in recovery from complex trauma and the founder of CTRN (Childhood Trauma Recovery Network UK). Betsy is also a qualified primary school teacher and is a mum of four brilliant sons.