/ 21 July 2023

Disentangle ourselves from our trauma

Graphic Tl Trauma Page 0001
(John McCann/M&G)
Dr Skye

I have been reading Bessel van der Kolk’s book on trauma, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. This new lens of insight acquired by his beautifully written learnings finds itself into my daily GP practice. Suddenly I want to ask every patient, what happened to you in childhood, tell me about that first marriage, what of those surgical scars? 

I’ve been thinking about loss and the intrinsic nature of grief in the human experience. Always this cycle of demise and reimagining, emerging from darkness, birthing through pain. No life is exempt from this. But there is something distinct between trauma and loss. Loss is inevitable. Trauma isn’t. 

There is a recurring theme in the physiology of pathology, where systems kick in appropriately, but then don’t switch off. We are designed for certain responses to activate when necessary and then to switch off for us to return to homeostasis. Examples are the inflammatory response, the stress response, periods of wakefulness and action followed by periods of rest and restoration. 

I recently interviewed Dr Ela Manga and she described so beautifully the necessary conversation between action and rest. The very quality of this life is seasonal, the tides, the sun, our breath. Even our birds know which part of the day is theirs to fill with song. 

Trauma changes the brain. It also changes the brain of the progeny of its victims. Multiple animal studies have proven that exposure of one generation of worms, rodents or insects to a specific influence can change the genetic expression of that generation’s progeny. 

Experiments on mice have shown that specific diets fed to the maternal mice led to changes in phenotypic expression in its babies. The sequence of their genetic codes remained the same, but certain genes manifested and others were switched off based on the diet of their mothers. This is called epigenetics. Your environment and the choices that you make can influence how your genes express themselves.

In another experiment rats were exposed to the smell of cherry blossom and a shock at the same time. They learned to associate fear and apprehension with the smell even after the shock was removed. The offspring that they produced were born with an inherent fear of cherry blossoms. This manifested beyond one generation. Isn’t that remarkable?

Everything from the weather and the scarcity or abundance of food to violence and nurturing can have an immediate effect on how we pass on our genetic code. So much of our current world is changing and at such a fast pace, it’s difficult to know the baby from the bathwater.  

What about trauma as an epigenetic influence? How does exposure to trauma in utero or during the developmental stages of life influence future generations? We know that the abused become the abuser. A cross-sectional study looking at South African men found that 88% of them had experienced either emotional, physical or sexual abuse. A third of these men had been violent with their intimate partner. 

More than 40% of South African women will be raped in their lifetime and only one in nine rapes are thought to be reported. This is chilling. It tells a harrowing story that doesn’t make headlines. 

One of the features of war veterans who leave the battlefield is that they display violent and reprehensible behaviours that their pre-war selves could never have inflicted. Trauma changes our brain chemistry and it changes our children. 

We have the power to reshape our world by protecting the vulnerable.

Research confirms that childhood abuse significantly increases a person’s lifetime risk for psychiatric disease, alcohol abuse and now also medical conditions like hypertension, diabetes and cardiovascular disease. Infants born to mothers who endured stress or psychopathology during their pregnancies have a higher incidence of behavioural anomalies.

As time quickens, the loss of “what was” infuses all of our lives. This brings us to an era where reimagining is more possible than even before. Bessel challenges the brain disease model in his book with the following four fundamental truths. 

l Our capacity to destroy one another is matched by our capacity to heal one another. 

l Language gives us the power to change ourselves and to find a common sense of meaning between each other.

l We have the ability to regulate our own physiology (even the involuntary parts) through breathing, moving and touching. 

l We can change social conditions to create environments where children and adults feel safe and are able to thrive. 

One of the characteristics of post-traumatic stress disorder is that a person is unable to remember aspects of their previous experiences, but they experience a sense of doom, shame, self-blame and hypervigilance. Their somatic stress response is unregulated and is triggered disproportionately to stimuli from their environment. This makes it very scary for them to feel or access emotion. 

Brain imaging of traumatised patients who are scanned while reimagining their trauma shows depression of the Broca’s area in the brain. Broca’s area is essential for putting our thoughts and experiences into words. One of the brain’s defences is to lose the language to name the trauma.

Dr Gabor Maté writes, “The attempt to escape from pain creates more pain.” 

The first step is awareness, the path to healing is remembering. When we all begin to name, observe, be curious about the parts of ourselves that are frightening, this is the first step towards healing. We are all carrying our own losses, pains, disappointments and also the generational weight of what we have inherited. 

We are more genetically similar to the worms and rodents I first mentioned than we might think. No doubt though, through language, dance, theatre, music and stepping together in time, we can begin to foster safety for our children and those that need support towards healing. 

Dacher Keltner, in his book, Awe, names a chapter “Collective Effervescence”. Experiments have shown that just the simple act of walking in step with one another is a bonding exercise that translates to increased camaraderie and goodwill between people. 

For every person that steps bravely towards confronting their own quietened traumas may another person step towards them in support. Slowly, we can disentangle ourselves from the shackles of what is past by integrating our trauma into the fabric of presence that is suffused with gratitude, openness, awe and wonder. 

Skye Scott is a GP with a special interest in patient education, integrative medicine and mental well-being.

The views expressed are those of the author and do not necessarily reflect the official policy or position of the Mail & Guardian