The Traumatized Brain

The orbital frontal cortex, which is the cortex just behind the eye sockets, reaches maturity between eighteen to twenty-four months of age. The right OBFC receives feeling information on the right side of the brain, and helps code it; it also helps control feelings and, above all, is involved in retrieving feeling information and integrating it with the left OBFC. This is a big job. Thanks to the right OBFC, we can know what we feel, and feel what we know; if only it will inform the left prefrontal cortex about what it knows and feels.

The right OBFC receives feeling information from below, from preverbal memories, and then provides a high level coding system that labels the feeling. What is important about the OBFC is that it has representations from the depths of the brain. In this way, we can make a connection between the awareness, and what happened to us even before birth. That is consciousness/awareness.

The right OBFC provides a map of our internal environment. Most early abuse and lack of love can be found coded there. If we want to regain conscious-awareness – full consciousness – we need to use the OBFC map to scan the non-verbal brain, the right limbic area and brainstem, to retrieve the most remote, ancient memories. Notice that I did not say “awareness,” which is left brain. Conscious-awareness is right-left brain working in harmony. We can be very aware and completely unconscious. We can be experts in politics or even psychology, and still not know what is inside of us. In fact, our hyper-alert awareness on the left can be motivated by the need to stay unconscious of the right. We can use he left prefrontal area awareness to dampen the amygdala/limbic areas and keep ourselves unconscious. I have cited earlier how in meditation the left OBFC becomes more active as the amygdala is less active. In some respects this is what happens in cognitive therapy; the left frontal area is stripped away from the right and treated as an independent entity. Thus, their efforts involve readjusting the left frontal brain to the neglect of other cerebral areas. Luckily or not, it is eminently adjustable and malleable. Ideas can be twisted and turned in so many ways; they can be “adjusted” so that we are convinced that we are feeling good when we are not. Thinking we feel good and really feeling good, involving the feeling centers of
the brain are two different things.

The right OBFC contains a model of what happened to us early in life. If we did not have a very strong emotional relationships with our parents early in life, the right hemisphere imprints will become a template for adult life that may cause constant broken relationships in adult life. We are victims of that template and then wonder what’s wrong with us when we cannot sustain an emotional rapport with someone. In that sense, it is more than a model; it is a fixed frame within which we operate. That frame is encased in biochemical chains, every bit as strong as links of steel. I have called this frame, the prototype (discussed elsewhere). The meaning is the same: lifelong patterns of behavior are organized very early in life, in pre-birth, birth and infancy experiences. The meaning is available to the right OBFC but not to the left. The patterns set up early in life become a guide for how we act in the future; for our adult compulsions and phobias as well as physical symptoms. That is why when we retrieve those early experiences with the right OBFC we can make immediate connections between our current symptom-- migraine, high blood pressure--and those early imprints. With the reliving the symptoms disappear, and we understand why. We carry around “broken relationships” inside of us all of our lives. We then develop a friendship with someone that soon breaks off, and it becomes a mystery as to why: the template. The template, as I have stated, involves all manner of biochemical processes. Thus, we may carry around very low oxytocin levels which helps determine how warm and close we can be to others. The brain’s neurochemistry, the levels of stress hormones and other activating chemicals, are all under right brain control. When these are altered they influence how we relate to others and to ourselves. In brief, we are rendered a different personality.

The traumatized brain has different cognitive capacities. It is not so much that one trauma compromises the brain; rather, it is an accumulated lack of love that does it. And lack of love means not fulfilling needs. When we consider that the right emotional/limbic brain is in a growth spurt in the first years when touch and love are absolutely crucial, it is clear that a lack of it will have lifelong consequences on our emotions. This is particularly true as the right brain relates to, and informs, the left intellectual side. Toward the end of the second year of life there is a leap in growth on the left side of the brain.

It is the right amygdala that forms a sensory gateway from feelings and sensations in the lower realm of the brain all the way up to the OBFC. This is where conscious-awareness lies. Connection means there is a flow between feelings that originate in the lower brain, and the higher-level frontal cortex, where thoughts occur. The amygdala also provides emotional information to the OBFC, which takes over some of the memory and codes it. When the amount of information is overwhelming the message does not travel all the way to the OBFC for connection. It can be blocked at the level of the thalamus and sent back down, retaining the disconnection. We then have a headless monster rummaging around the lower depths of the nervous system without guidance.

People who feel uncomfortable in their skin, sense that rummaging monster but don’t know what it is. They just feel that they want to jump out of their bodies. It is not difficult to understand someone who has an “out-of-body” experience. Those with terrible first line pain do sometimes have “out-of-body” experiences where they leave their corpus behind and travel to another dimension. It is another way the defense system works; it is the flight from the pain on the right to the left brain with its imaginary powers. The person has made the leap out of himself—out of the feeling self--to an imagined state.

We see intrusion of this “monster”, literally, in our sessions when a patient will be reliving something from early childhood and suddenly be seized by a coughing jag, her feet and arms changing to fetal position. Here we have tapped into a childhood pain that has roots deeper in the brain. Sometimes the intrusion continues, such as a loss of breath, and interferes with a full reliving of a childhood event. If the patient is not ready for the deeper experience, we may recommend first line blockers such as Clonidine or Xanax. If the patient is ready for the first line experience, we may go there. This is rarely done in the first months of therapy.

The weakness or damage to the OBFC is often seen in our disturbed patients who relive first line events in the first days of therapy. We know from this that there was very likely pre-birth and birth trauma. We know, too, that there is infancy/chilhood compounded pain which has compromised the gating system. Institutional children and those placed in foster homes early in life, relive these traumas very soon in therapy.

There are reciprocal nerve fiber connections that run from the OBFC down to the brainstem. Terror that’s imprinted down low in the brainstem, in the locus ceruleus, for example, can send out noradrenaline to activate us; we become hypervigilant.

The locus ceruleus can activate us due to pain but it also contains a good number of opiate receptors to help suppress it. Traumas while we are being carried may redo the set-points of noradrenaline so that we are more hyped up from the start of life. And hyper-secretion of noradrenaline over years can and does adversely affect the heart. In other words, the seeds of later heart disease may have their beginnings even before birth. Is it any wonder that later disease seems to occur without any obvious current reason? Since noradrenaline is related to fear and terror, it will ultimately mount to the frontal area and affect our thinking processes.

Scientists have found locus ceruleus/noradrenaline fibers in the thalamus; in this way low level activation reaches the relay station to be sent to higher centers, finally interfering with our concentration. Not surprisingly, morphine and valium can suppress this activation and calm the pain. External morphine can help when we cannot produce enough of our own—endorphin. The result is the same, repression and calm. Left brain ideas can help stimulate the endorphin output to put down pain. Herein lies the reason for belief systems that embody hope. And herein lies the problem and so-=called success with cognitive therapy: using the wrong brain to do the work of another. The left can never do the right brain’s work. It can smother it for a time, however, with ideas and beliefs.