Polyvagal Theory and Trauma – Dr. Stephen Porges

In the 1960s, American neuroscientist Paul MacLean formulated the ‘Triune Brain’ model, which is based on the division of the human brain into three distinct regions. MacLean’s model suggests the human brain is organized into a hierarchy, which itself is based on an evolutionary view of brain development. The three regions are as follows:

1. Reptilian or Primal Brain (Basal Ganglia)
2. Paleomammalian or Emotional Brain (Limbic System)
3. Neomammalian or Rational Brain (Neocortex)

At the most basic level, the brainstem (Primal Brain) helps us identify familiar and unfamiliar things. Familiar things are usually seen as safe and preferable, while unfamiliar things are treated with suspicion until we have assessed them and the context in which they appear. For this reason, designers, advertisers, and anyone else involved in selling products tend to use familiarity as a means of evoking pleasant emotions.

The word ‘trauma’ originates from the Greek word ‘wound”, which at the time, was primarily used to refer to physical injuries. Today, trauma is also frequently used to refer to “emotional wounds” that can cause psychological symptoms any time after the traumatic event has occurred, including years later. Emotional and psychological trauma can be lifelong.

The word ‘trauma’ has been popularised, and is arguably used carelessly or inaccurately, to indicate almost any kind of unpleasant experience or stressor by an individual (Haslam, 2016). A stressful life experience is more commonly being labelled as trauma or a traumatic experience. While both stress and trauma can impact our wellbeing, we must differentiate the two for diagnostic and treatment purposes within the mental health field.

Emotional and psychological trauma is associated with significant unexpected incidents that are, or perceived as, threatening to a person. The most recognised examples of traumatic events include unexpected natural disasters, a serious car accident, war, rape, bullying/intimidation, or losing a loved one. Traumatic experiences are often described as overwhelm the nervous system and experienced as deeply distressing events, and adverse short or long-term impacts are commonly experienced. It is also worth noting that some people may not recognise they have experience trauma. I once heard a story of a boy in high school who accidently severed a major artery of his peer with a school prop while joking around. His peer was taken to hospital and survived, but ears later he began having night terrors of the incident.

The following is a definition from the Substance Abuse and Mental Health Services Administration (SAMHSA) in the United States: “Individual trauma results from an event, a series of events or a set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.” (SAMHSA, 2014a, p. 7)

“Traumas can affect individuals, families, groups, communities, specific cultures, and generations. It generally overwhelms an individual’s or community’s resources to cope, and it often ignites the “fight, flight, or freeze” reaction at the time of the event(s). It frequently produces a sense of fear, vulnerability, and helplessness.” (SAMHSA, 2014b, p. 7)

The determinants of acquiring post-traumatic symptoms are influenced by how individuals interpret their circumstance(s), their developmental stage, cultural beliefs, availability of resources and support, and the physical and psychological disruptions they experienced (SAMHSA, 2014b). I have heard the word ‘trauma’ used to describe neglect and abuse during childhood. It’s important to note that while some caregivers may have neglected the emotional and psychological needs of a child, or used ‘smacking’ (positive punishment) to discipline children, not all individuals will develop symptoms that meet the current criteria by the Diagnostic and Statistical Manual (DMS) for Trauma. It is fair to say that all people have likely experienced life stressors that have conditioned them to think, behave, and react emotionally in specific or general social contexts, and will effect their quality of life and health.

As a rule of thumb, for trauma to be classified as a clinical psychological or emotional condition, I consider the 4 D’s: is there post-traumatic symptoms of DISTRESS, DYSFUNCTION in daily living, DANGER (to self or others), or DEVIANT behaviour. I think the word ‘deviant’ has prejudicial connotations so to clarify, it means departing from usual or accepted standards, especially in social or sexual behaviour.

Thank you for reading. Of course, there’s plenty more to say on the topic of emotional and psychological trauma, especially how cultures differentiate it from more commonly experienced yet individually meaningful life stressors. Stress that doesn’t fit the clinical criteria of ‘trauma’ is still valid and can be detrimental to our health. It can be helpful to seek psychological or psychiatric treatment, or spiritual alternatives to traditional Western health care.

References:

1. Haslam, N. (2016, August 15). The problem with describing every misfortune as ‘trauma’. Chicago Tribute. From website.
2. Substance Abuse and Mental Health Services Administration (SAMHSA, 2014a). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. Substance Abuse and Mental Health Services Administration. From website.
3. Substance Abuse and Mental Health Services Administration. (2014b).  A treatment improvement protocol: Trauma-informed care in behavioral health services TIP 57. From website.