Neurobiology of Trauma Etiology Reversal
(Biology of Resolution)
Principles of Resolution
Within ETM theory and application, there are 3 facilitation principles
for reversing trauma etiology, and using the patient perspective synonym
- "resolving trauma"; the principles pertain to the biological dynamics
of reversal - resolution. They are described here.
Clinical Use of Existentialism
The "clinical use of existentialism" refers to the application of methods
that generally emphasize "acceptance of the person," as opposed to methods
that emphasize the "need to change behavior" or methods that enforce compliance
with social norms. Grief resolution provides an example of an acceptance
modality. The clinical use of existentialism accords a special value to
the biology of resolution. Once that reinstatement or reconstitution of
identity is initiated, the brain integrative component will provide for
the necessary alterations or realterations in neuronal functional and structural
chemistry, including finding the appropriate combinations between experience
and the time required for neuronal (synaptic and dendritic) growth to complete
the integration started after the event occurred. The brain integrative
process is facilitated through neuronal learning. It is described
in the next subsection.
The clinical use of existentialism is also considered to be a necessary
counter to the first interfering variable, stoicism; if stoicism were not
the predominant philosophy of life, there would be little need for the
emphasis on existentialism.
Neuronal Learning
Generally, the term "neuronal learning," as it is applied to etiology reversal,
refers to the neurological process through which the neuronal functions
and structures of pre trauma existential identity are reconstituted into
functional and structural modes equal to or the same as those that existed
before the trauma occurred, but within the context of the current and new
reality. Specifically, "neuronal learning," when used in the context of
Trauma Resolution Therapy's application, refers to the processes through
which:
long-term potentiation is strengthened for memory system two, the most
integrative component of memory and the component that is placing the contradictions
and the recollections of the event into past tense.
the traces that retain the contradictions and the event as ongoing
experiences are inhibited; contradicting and ongoing-event-recollection
trace's LTP's are reduced.
Long-term potentiation of the existential identity that existed before
the event occurred is returned to its pre-trauma functionings: the pre-trauma
probabilities that the synapse will transfer an action potential are restored
to the probability levels enjoyed before the event affected the synapse.
Memory system three (the survival system) is inhibited.
Caring
"Caring" means that one or more people, other than the trauma victim receiving
the clinical application, focus their energies, attentions, thoughts,
behaviors and emotions on the brain integrative process for the particular
trauma affected person to which the therapy is being applied, and as that
person is negotiating the integrative process. This "focus" translates
during the clinical application to a conflux of identities: interactive
support for the integrative process to the degree that neuronal learning
is facilitated.
TRT's Structure Intercedes Upon Etiology:
the Neuronal Effects of Psychological Trauma
TRT intercedes upon the neuronal effects of psychological trauma at 4 levels;
the intercession facilitates the brain integrative response to trauma.
This subsection explains that intercession.
The TRT Structure Removes the
Influence of Interfering Variables
TRT's structure prevents the more obvious interferences with the
brain's phylogenetic integrative capacities to do its job. That is, interfering
variables are prevented from use as a condition of the therapy's administration;
patients don't do stoicism philosophy or drugs during the course of the
structure's application.
To preclude the use of stoicism philosophy means: prevent the use of any
survival system (3) strengthening methods; such survival strengthening
methods can include teaching people to be responsible, mandating their
accountability, and helping them to regain or maintain control through
the repetitive use of cognitive-behavioral applications -- slogans.
I'm aware that these methods are held in high esteem within our society
and that setting them aside during the application of TRT will be, for
some people, difficult. However, these methods, born of stoicism philosophy,
will only interfere with the phylogenetic integrative process; they should
not be utilized simultaneously with TRT, regardless of their philosophical
and methodological merits when they are being applied to other situations,
like when learning to be a good citizen, conscientious marital partner,
or valued employee.
Moreover, people can still be taught to be responsible, accountable, etc.,
after TRT is over, assuming they (the patients) still need the advice.
Our experience has always been that they usually do not and that offers
of such advice are only required when no one surrounding the trauma victim
knows how to reverse the etiology.
When we say that drug use is precluded, we are speaking of discontinuing
the use of opiates (exogenously introduced), pharmacological therapies
and alcohol. These exclusions extend to the periods between sessions. Obviously,
chemically dependent people have to stop using drugs entirely before they
can participate in TRT -- the biology of chemical dependency is addressed
in the referenced bibliographical section. Observations of the effects
of the various kinds of drug use on the application of TRT are provided
in About/ Theory/ Drug Use. The pharmacological
therapy issue is addressed in the often referenced bibliography..
The prevention of the use of these interfering variables provides for the
application of existentialism during the administration of TRT. As indicated,
the clinical use of existentialism provides for a return of the brain's
integrative phylogenetic capacities which have been interrupted by the
unbalanced emphasis placed by the interfering variables on memory system
three (the survival system). Once the therapy is completed, participants
can return to the use of the survival philosophy or drug of choice (excepting
chemically dependent people) without concern that such philosophies or
use will interrupt the brain's integrative functions (as they are related
to the trauma-causing event and effects at issue). This does not mean that
we recommend social drug use as a life-style; the lifestyle is not a subject
of this book.
The TRT Structure Directly Inhibits
Memory System Three (Temporarily)
In addition to the inhibition of memory system three through the strengthening
of memory system two, the TRT structure also has a directly inhibiting
effect on memory system three while the therapy is being applied. This
effect is facilitated through the use of the structure to describe the
trauma-causing event, the emotional response to it, the contradictions
to existential identity, the losses that have resulted from the contradictions,
and the identification of the specific survival responses. Through this
therapeutic experience the specific neuronal processes involved in providing
the denial proffered by memory system three are themselves countered --
inhibited. In addition, the integrative command will begin to rely on the
use of the structure more so than rely on the survival system. This new
reliance on the structure also directly inhibits memory system three. And
finally, the specific injunctions by the therapy to refrain from engaging
in behavioral-change activities while doing the therapy (see "How to Do
TRT Phase Three"), not only support the use of existentialism as the principal
underpinning of the reinitiation of the brain integrative command, but
the injunctions (if followed) also directly inhibit the survival memory
system three by providing a direct (cognitively applied) counter to its
use.
These direct inhibitions on survival memory system three are not adequate
by themselves to reverse the long term potentiation developed by memory
system three and that is still responding to the organism's natural need
for a new memory system to manage the organism while memory system one
is still incapacitated. The reader will recall that this incapacitation
is a result of extinction (caused by the traumatic event) of the neuronal
traces comprising the existential aspects of identity and that the primary
means of ending the need for memory system three completely is the restoration
of memory system one to its pre trauma existence and functioning.
Such restoration occurs through the strengthening of memory system two.
Thus, the direct inhibitions of memory system three provided during the
application of TRT are only temporary, stop-gap, influences; if the use
of the structure is abandoned before memory system two has been fully strengthened
and before existential identity is restored to its pre-trauma neuronal
functional efficacy (= a return of LTP to its pre-trauma levels), memory
system three will return to its post-trauma functioning and possibly again
dominate systems one and two.
In other words, the direct inhibitions of memory system three, provided
by the structure during TRT's application, are only intended as temporary
methods that facilitate the use of the structure to strengthen memory system
two and return the existential identity neuronal processes to pre-trauma
functionings. This is accomplished, in part, through the structure's
influences on PSR.
The TRT Structure Returns
PSR to Optimal Functioning
The reader will recall from reading the previous chapter that PSR is interfered
with through exogenous influences; they directly impede the PSR functions.
Such influences include stoicism philosophy; it interrupts the distress
vocalizations and supports denial of the memory of, and the pain associated
with, the event. Moreover, drug use directly medicates the neuronal systems
involved in providing those signalling components of PSR. Where a previous
subsection explained how the interfering variables are excluded from the
therapeutic process, and such exclusion returns the brain's integrative
process to its usual functionings, this subsection describes the influence
of the TRT structure on the return of the specific functioning of PSR to
its ordinary capacities. This return supports the overall brain integrative
function and the strengthening of memory system two.
A note before proceeding. We discuss signalling first and then protection,
as the structure provides for the reinitiation of the signalling component
first.
Signalling
The beginnings of the TRT structure (TRT Phase One) provides for the identification
of the event and the emotional response to the experience. Identification
of the event itself removes the influences of survival memory system three's
inhibiting effects on that recollection. The signal, the recollection of
the event as ongoing, is fully restored. Accompanying this restoration
is the use of distress vocalizations -- full and unimpeded catharsis. Importantly,
the structure provides that this signalling is not only fully received
by the organism and other people, but the structure also provides for a
specific response from both the trauma victim (strengthening of memory
system two) and these people. These two signalling methods will be used
effectively within the parameters of the structure's application until
they are no longer needed -- when memory system two places the contradicting
influences upon the neuronal traces comprising existential identity into
their historical context. Importantly, signalling will never disappear
(albeit, they may again be quashed from consciousness through the resurgence
of memory system three) until the contradicting inhibiting influences on
identity are removed.
Protection
As previously explained, protection involves the use of alarm (fear) response
and the use of analgesia to protect the organism (and its psychology) from
the pain of the event, to include protecting the person from the experience
provided by the distress vocalizations. In that regard, when the TRT structure
provides for the descriptions of the event and the emotional responses
to it, the experience of the fear is felt as it should be felt and unimpeded
by interfering variables or the over-influence of memory system
three. Like the experience of distress vocalization, the fear experience
also facilitates strengthening of memory system two. Analgesia, another
protective ingredient against pain, is also stimulated during the application
of TRT's structure.
Importantly, the brain's integrative process, if unencumbered by the interference
of disintegrating exogenous influences, will use the proper amount of fear,
distress vocalization and protective analgesia that is appropriate for
each person. In that regard, although the structure makes the use of these
protection and signalling mechanisms available again and without encumbrance/impairment,
it is the brain's integrative function that determines the degree of their
usages. Thus, the existential variable of the therapy provides the brain's
integrative component with the opportunity to coordinate this person's
appropriate, that is, phylogenetically derived, interactions between the
usages of signalling and protection.
A behavioral example of this phylogenetic effect is the cyclical experience
of psychological movement between intense catharsis and numbness (denial)
during the process of grief; the person will grieve deeply, making loud
exclamations while crying (produced by the failure of opioids to bind on
their appropriate receptors), and then stop crying and feeling altogether:
a period of numbness (produced by the analgesia) ensues, which is then
followed again by grieving and crying.
Remedy
The effective use of the remedial components, to include the prolific production
of adrenaline and noradrenaline for the purposes of enhancing neuronal
learning, is reinitiated with the reinitiation of the unimpeded signalling
and protection components of PSR. This neuronal learning enhancement is
described in the next and last two subsections.
The TRT Structure Directly
Strengthens Memory System Two
The reader will recall that memory system two is the integrative system
that, through its growth and addition of the synapses and supporting morphology
comprising the trace and strengthening of LTP, places the contradiction
to existential identity (the inhibitory trace of memory system one) and
the recollection of the event as an ongoing experience into its historical
context. That "placement" has usually been, however, interfered with --
exogenous influences have strengthened memory system three's predominance
over two and retarded the effectiveness of PSR, the processes needed to
enhance neuronal learning.
As TRT's structure innervates PSR, inhibits the influence of memory system
three, and restores the brain's use of phylogenetic (integrative) capacities,
memory system two is allowed to continue its development. In addition to
indirectly aiding system two's natural development, TRT's structure also
has a direct bearing on the facilitation of the growth. This facilitation
occurs through the identification, that incorporates the use of behavioral
techniques, of the event causing the trauma; the values, beliefs, images
and realities contradicted by the event, the contradictions themselves,
and the loss that has resulted from contradictions.
"Behavioral techniques" refers to the methods through which the trauma
victim is instructed to record these factors (the event, identity, contradictions,
and loss) in the past tense. This recording is consciously initiated and
emphasized repeatedly in writing; the recording is maintained with the
support of the feedbacking processes (see Clinical/ Long-Term Trauma/ TRT
Phases One - Five).
The effect is the cognitive-behavioral (direct) strengthening of long term
potentiation of the neurons comprising the memory system two trace. Simultaneously,
similar recording and expression of the emotional experience, supported
by the feedbacking process, initiates PSR -- the emotional experiences
(the experience of fear and distress vocalization) stimulate the prolific
use of adrenaline and noradrenaline which enhance the learning ongoing
in the memory system being focused upon through the combined cognitive-behavioral-experiential
methods. LTP of the memory system two trace is strengthened rapidly.
Simultaneously, this strengthening is accompanied by neuronal structural
change. That is, new synapses and dendrites used for connecting synapses
and carrying the retrograde chemical messengers that reinforce LTP are
grown, changed, or altered (cell plasticity is dramatically influenced).
This physical change does not happen overnight. It takes as long as it
takes; for some people and some kinds of trauma, the changes in synaptic
plasticity may take hours. Others take weeks or months to develop the required
synapses to effect neuronal learning: accommodate the entire trauma resolution
process.
When the TRT structure is properly administered, it seldom takes longer
than 1 year to complete the entire growth process, even for people who
have been affected by the severest of traumas (including repetitive exposure
over long periods to like trauma-causing events). Moreover, in our experience,
the combined cognitive-behavioral-experiential process available through
the application of the TRT structure will facilitate this neuronal change
much more rapidly and precisely, and without a loss of the existential
element required by the integrative process, than through the use of psychodynamic,
to include grief, methods that do not use the structure.
The TRT structure's provision for the identification of the kind of (specific)
loss, for example self-esteem, self-worth, trust, safety, security, family
pride, etc., that result from the specific contradictions to existential
identity, provides for the final neuronal strengthening of the memory system
two. This strengthening involves the memory system two's neuronal learning
to the degree that the learning serves as a measurement of the difference
between the identity that existed before the trauma, the depreciation to
that identity resulting from the trauma, and the restoration of the identity
(see the last subheading entitled "Memory System Two Restores the Existential
Identity Trace").
Through this neuronal measuring/learning process, memory system two places
the loss, the contradictions, and simultaneously the event as it has been
recorded in memory as an ongoing experience, into a historic context. This
placement occurs through inhibition of the contradicting trace and inhibition
of the ongoing event trace to the degree that they are now becoming extinct.
Under the definition of extinction, two things must happen: something new
and countervailing is learned simultaneous with the reduction in LTP. In
the case of resolution, the contradiction's and the event's becoming past
tense are the new something that is learned and the LTP representing the
old traces of the contradictions and the event as an ongoing experience
are the LTP's that are reduced.
Extinction of these traces means that inhibitory influence affecting the
original traces representing existential identity no longer exist -- the
efficacy of LTP in the existential identity trace is restored. Moreover,
the use of the cognitive (writing) methods for identifying existential
identity contradicted by the trauma, also directly influences the return
of that efficacy.
Restoration of existential identity LTP culminates in the ending of the
incapacitation to the organism's psychological management, the ending of
the need for the survival memory system three, and the ending of the need
for PSR -- no more fear and fight or flight responses, distress vocalizations,
ongoing memory recall, or trauma-induced adrenaline/noradrenaline activity.
The trauma resulting from the contradictions to existential identity is
resolved; the biological etiology is reversed.
Memory System Two Restores
the Existential Identity Trace
In this and the previous chapter, much has been made about "restoration"
of pre-trauma existential identity traces to their pre-event configurations.
Additional explanation of this restorative process is required as it is
influenced by the nature of the identity being contradicted and the circumstances
surrounding the restoration.
The reader will recall that the event results in an opposite learning experience,
which is one of the two elements of extinction, the other being a reduction
in LTP. Moreover, the opposite learning experience, or the contradicting
trace, is stored existentially also. That is, where the original trace
is stored as an "Is," the contradiction is stored as an "is not," which
results in a paradoxical (opposite) condition. Because there would be no
contradicting trace without the trace being contradicted, the two traces
are mutually inclusive -- they are interlocked into this paradoxical state
of opposing truths.
When memory system two inhibits the contradicting trace, and the LTP of
the existential identity is increased again to its pre-trauma levels, this
is acceptable to the integrating component of memory system two when the
value originally contradicted does represent the current reality. For example,
a battered spouse may say during the integrative process that her or his
values before the event were that he or she should not have been beaten,
or life threatened. Neuronal restoration in this case translates psychologically
to the acknowledgement that she or he should not be beaten, or life threatened,
now. In some cases, however, the pre-trauma trace may no longer be applicable.
For example, where death of a loved one either accompanies the trauma or
represents the event, the reality that "my loved one is supposed to be
alive" is no longer appropriate. In such an example, the memory system
two will inhibit the contradicting "is not" trace and supercede it with
an integrative command -- "My loved one was alive." The existential
identity, including all the memories related to the life of and relationship
with that loved one, will be characterized as something that once was.
As the changes are made, the integrated change, that is, the "this was
the existential identity" trace is no longer in conflict with the "is not"
trace providing the original contradiction to existential identity. The
opposite no longer exists. Thus, the paradox that results in the need for
PSR no longer exists. The trauma is resolved; the biological and psychological
etiologies are reversed.
