What is trauma?
Trauma is not just an individual experience—it reverberates, resonates and has the power to impact anybody and everybody. The aftermath of the Manchester bombing during an Ariana Grande concert is a stark reminder of how trauma’s echoes can be felt widely, affecting not only the individuals directly involved but also those indirectly connected, such as families and entire communities.
In this blog post we will explore the experience of trauma Ariana Grande has shared, in addition to the audience members who would have also been deeply affected.
Understanding Trauma
People who have experienced trauma may be more vulnerable to developing physical and mental health conditions such as, post-traumatic stress disorder (PTSD). When we experience trauma, our brains go into survival mode and direct all mental and physical efforts towards dealing with the threat. The Amygdala, hippocampus and prefrontal cortex are the key areas responsible for this; they all work together to overcome stress. However, sometimes the initial stress response to the trauma can stick. This is when PTSD and other trauma-related disorders can occur.
The symptoms of PTSD and brain-related changes
After the Manchester bombing, Ariana Grande shared that she experienced feelings of anxiety and guilt. She felt she couldn’t breathe and had difficulty even speaking about what had happened and was consequently diagnosed with PTSD. Other common PTSD symptoms are flashbacks and nightmares of the traumatic event, loneliness, anger, intrusive thoughts, intrusive memories and even physical symptoms such as stiffness and pain. 
Research has found that the brains of people with PTSD, have been changed structurally and chemically which alters its normal function. The amygdala, hippocampus and prefrontal cortex are the main areas affected. Grande famously shared photos of her brain scan to her social media, comparing it with an example of a healthy brain and the brain of someone with PTSD; her own brain scan shared more similarities with the one with PTSD.
The body’s response to threat
To understand this on a deeper level, we must first understand how the brain responds to threat. To simplify; the amygdala will detect a stressor. It will then send a signal of threat/stress to the prefrontal cortex which will help to regulate the amygdala and reduce the feeling of stress. The hippocampus is responsible for logging the information as memories each time. In situations of high stress/threat the functioning of both the prefrontal cortex and hippocampus become impaired, so information is not processed or stored correctly. Information from the amygdala doesn’t reach the prefrontal cortex and the body goes into its innate response of fight, flight, or freeze.
The amygdala after trauma
The role of the amygdala is to be the emotional response centre of the brain. When someone develops PTSD, the amygdala becomes more active. Therefore, when faced with a stimulus which is a reminder of a trauma, it’ll activate the fear response, even if there is no real danger. For example, for someone who has been to war, the sound of a car backfiring can trigger a fear response as it mimics the sound of gun fire.
The hippocampus after trauma
The hippocampus is responsible for memory and learning in the brain. In patients with PTSD, the hippocampus has been found to be smaller, decreasing its function. This makes it harder for the patient to distinguish between the past and the present; they lose the ability to differentiate between the actual traumatic event and memories of it, so the memories become threatening in themselves.
The prefrontal cortex after trauma
The prefrontal cortex is in control of executive functioning and higher levels of thinking and reasoning. It has been found to have both decreased function and activation when exposed to traumatic reminders. Therefore, it is less capable of controlling fear and becomes stuck in a reactive state.
Other brain changes found in PTSD
Trauma can create changes in the salience network which is a brain network associated with the sense of reward. It also plays an important role in learning and survival.
A recent study by the University of Rochester found, with fMRI technology, that people with PTSD had less signalling between the hippocampus and the salience network, as well as less signalling between the amygdala and the default mode network (activated when someone isn’t paying attention to external factors). This shows that people with PTSD struggle to distinguish between the traumatic event and a reminding stimulus but only when an emotional component is involved.
Interestingly, they also found changes to the salience network in trauma resilient people (those who have experienced trauma but not developed psychopathologies because of it) as well as people with psychopathologies. This is because the trauma-exposed resilient people had compensated for the changes to their brain by engaging the executive control network, which is responsible for decision making. How has this occurred? Perhaps due to neuroplasticity.
Neuroplasticity and the Treatment of PTSD:
Brains have the incredible ability of neuroplasticity. This means that they can form and reorganise synaptic connections, which can change the functioning of the brain and essentially, rewire it. This means that someone who has PTSD can recover from it by changing how their brain works. It is unlikely for the brain to completely recover by itself however, with the guidance of treatment, a recovery from trauma is possible.
Going back to our case study, Ariana Grande has revealed she went to therapy to treat her PTSD and she has since begun to perform again, creating music as she was before, occasionally drawing on her traumatic experience.
Learn how to repair the damage caused by trauma:
One example of an effective treatment for trauma is neural desensitisation and integration training (NDIT), developed by Dr. Jennifer Sweeton. This flexible, client-centered approach combines elements from other methods such as eye movement desensitisation processing (EMDR), internal family systems (IFS) and cognitive behavioural therapy (CBT). With strong roots in neuroscience, NDIT can be used to restore healthy brain functioning by focusing on the 5 modules targeting skills associated with healthy brain change, which target the affected brain regions.
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