On a witness stand, a woman testifies about a sexual assault she experienced decades earlier. No one believes her testimony because she can’t recall certain details, and she doesn’t seem at all distraught. She doesn’t waver on the identity of the alleged attacker but seems confused when pressed on the logic of her own actions that night.
Ensuing comments on social media point to these apparent inconsistencies; even some who believe her account remark, “I went through the same thing and didn’t need to make a big deal out of it. And why is she telling her story so long after the fact?”
This sort of thing happens far more often than most of us realize, especially when the trauma involves sexual assault or childhood maltreatment. If an assault occurred, would the victim really wait so long to accuse the perpetrator? Even if the answer is yes, why is he or she still suffering when others say they’ve been through similar situations without experiencing the same scars? Are some people just better at pulling themselves up by their bootstraps? Have they then earned the right to expect that everyone else should “just do the same”? While it takes resilience to recover from a traumatic experience, it’s important to honestly answer two questions: “In my case, where did that resilience come from?” and “Has this other person had access to the same resources I had?”
We’ll look at some of those resources, but first, let’s acknowledge an unconscious but common human bias. Sometimes called the “just world” bias, it suggests that our world is inherently fair. Those who work hard enough will become mentally strong and will therefore succeed (this would be us). The lazy and lax, on the other hand, are doomed to poverty and/or mental-health issues, because that’s just how life works.
This natural bias is hard to overcome. Yes, given the right conditions, hard work plus good character pays off. Yes, there are lazy people whose situations can largely be blamed on their own lack of effort. However, it is not a universal truth that hard workers always succeed and that those who don’t are personally responsible for their poor situation.
This is especially true when it comes to traumatic stress. The ability to bounce back from stress or trauma is called resilience, but we don’t achieve it by sheer force of will. There might be any number of reasons why one person’s stores of resilience are higher than another’s.
We’ll focus on five factors that help shape our baseline capacity for resilience. Some can be chalked up to nature and others to nurture.
1. Nature: Inherited Wiring of the Brain
Genetics can influence people’s risk for mood and anxiety disorders (including PTSD). A predisposition may be hard-coded in our DNA, but a long history of animal studies and now a growing number of human studies suggest that it may also be passed down through epigenetic tags from parents or grandparents who faced trauma. In particular, a mother’s trauma during pregnancy is directly related to her child’s brain development.
Just as in any area of research, figuring out exactly how these processes work is a one-step-at-a-time journey, but it may not all be bad news: the epigenetic effect may be protective in some circumstances.
“Recent studies show that fear might actually leave permanent epigenetic marks on your DNA, marks you could potentially pass down to your children or grandchildren.”
2. Nurture: Early Environment and the Quality of Attachment
We all “attach,” or form emotional bonds, with significant others; it’s what the human brain does. But the quality of that attachment varies for any number of reasons.
The first few years of a child’s life are especially critical for developing emotional regulatory systems. These are physically and chemically programmed by the quality of support offered by the important adults in a child’s life. When they’re responsive to children’s emotions and help soothe them, children learn to soothe their own emotions. But it’s more than simply learning. The process is actually biological. When a parent or other caregiver responds to a child’s distress, this causes the stress chemicals in the child’s brain and body to return to a state of harmony, or “attunement,” with the caregiver—which is the optimal state for imprinting healthy stress circuitry.
Ruptures in this harmony will occur, of course. But the caregiver’s efforts to repair them are what will gradually build a child’s ability to return, independently, to a state of equilibrium. A child’s emotional circuitry during this period can thus be primed to be resilient to stress, while an unresponsive or abusive environment can make a child highly susceptible to mood and anxiety disorders later in life.
As important as the early environment is, however, two children from the same loving, responsive household may develop different levels of resilience because they’re starting out with different inherited predispositions, as mentioned earlier.
3. Nurture: Interpersonal Environment and Personal Support Networks
Even if you consider yourself an introvert, you need people as much as anyone else does. In any case, most of us are neither introverts nor extraverts but rather ambiverts—falling somewhere between the two extremes. Every human brain depends on health-infusing connections with family, various communities and the wider world. A person’s faith is part of the interpersonal environment; psychologists acknowledge that religious affiliation can be a powerful support resource. (However, the unscrupulous can also use religion to abuse and control others.)
Of course, people don’t always have the luxury of choosing their interpersonal environment. The family we’re born into determines to a great extent what our other communities will be like and how available supportive relationships might be.
But that isn’t the only factor. In a strange way, our inherited wiring comes into play too. For instance, some people may have inherited low resilience. If they have also experienced trauma during key developmental periods in childhood, and if their caregivers’ interactions with them were extremely inconsistent, then as adults they’ll likely find it very difficult to connect emotionally with others. They’ll misinterpret social cues and give confusing cues to others. They may start believing they’re unlovable, a belief that will be continually reinforced by the way others respond to their confusing behavior.
This cycle can certainly be broken. But the biological nature of the problem requires the help of supportive others. If we think of stress networks in the brain as being a bit like our muscle network, then an interpersonal support system is like our spotter in weight training—helping us lift beyond our capacity until our body physically changes and we become capable of doing it on our own.
4. Nurture: Cultural Attitudes and Wider Community Networks
The availability of individual, financial or community support programs for people with mental-health needs depends in part on cultural attitudes. For example, in cultures where needing help is seen as a sign of weakness, community programs may not be a priority. Even if they do exist, the social stigma can keep those in need from asking for help.
“We set up Heads Together, which is a campaign to try and tackle the stigma around mental health, because we thought if we could tackle the stigma, that was one thing that would allow these mental-health charities to do more of their work.”
Cultural attitudes can also affect family members, influencing whether they’re responsive to a traumatized relative’s need for emotional support. These attitudes may make the difference between sending the message “I’m here for you” or, conversely, “Why can’t you just get over it, like I did?”
5. Characteristics of Our Trauma Experience
While our reaction to trauma may be shaped as much by our inborn capacity for resilience as by the number or severity of stressful events, some types of trauma are especially harmful. Long-term and cumulative exposure can cause the brain’s stress response centers to remain at high alert for extended periods of time, and this can be physically damaging. Someone who experiences a single traumatic incident will likely come through it differently than someone who has experienced multiple episodes of a particular trauma, or the cumulative effect of different types of trauma over time.
But even taking these factors into consideration, researchers have noticed significant differences in the severity of symptoms between types of traumatic experience.
One characteristic that ramps up the severity of effects is betrayal. Family dysfunction such as domestic violence or child abuse, for example, tends to cause more psychological distress than grief or loss would. And the closer the family tie, the more severe the effect. A trust-based relationship has been betrayed, leaving the survivor in conflict between the inherent need to connect with the family member and the need for self-protection.
The way trauma survivors evaluate their experience also affects the severity of their reactions. When they blame themselves, or if they view their own behaviors and thoughts in a negative light, they’re likely to have more severe symptoms of depression and posttraumatic stress. Children particularly tend to blame themselves for betrayal traumas, but adults—both men and women—do it as well. And family and community members often encourage this by joining in the finger-pointing.
While we could look to more factors, these five should give us pause when we’re tempted to compare ourselves to others. We all wish there was an “easy” button that those suffering the effects of trauma could push so they wouldn’t require so much of our help. It can be tempting to think that “if they would just think positively, I wouldn’t have to reach out. I’m just not comfortable around them. I get over the difficulties in my life; why can’t they get over theirs?”
Yes, exercising love and selfless concern can be hard work, but we can’t see ourselves as somehow superior; we may have had access to resources that someone else did not. Each of us is likely unique when it comes to resilience, given that we each spring from a particular combination of nature, nurture and epigenetics. If we happen to be among the strong ones, it can be an enormous privilege to serve as “spotter” for others who may struggle to lift their burden and build their resilience “muscles.” But if we fail to recognize that we didn’t build ours alone, we may miss out on the educational and fulfilling experience of helping someone else.
It’s useful to first understand how trauma affects the brain and the body, and by extension, memory and behavior. This requires that we see the brain as an integral part of the body. The debate about whether mental-health issues cause inflammation or vice versa is pointless, because mental and physical health go together. You can’t address a mental-health issue by involving only the brain or only the body. Just as not caring for your body (in terms of diet, sleep and exercise, for instance) can lead to inflammation, so can mental and emotional stress when it triggers a negative hormonal response. Current research in epigenetics also suggests that psychological and emotional trauma can interfere with areas of the brain that help prevent inflammation.
Understanding that we don’t have two separate control centers—that both the brain and the body are deeply affected by our physical and emotional environment—makes it much easier to understand why people can have very different responses to trauma.
In the face of ordinary stress, the brain assesses the potential threat and, through neural and endocrine circuits, kicks off a “group chat” with the body’s cardiovascular, immune and other systems. The autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis then respond with a “fight, flight or freeze” message. This serves us pretty well in the short term. The brain’s messages trigger hormones that put on hold any physiological and cognitive systems that aren’t really necessary for the time being so the more relevant systems can kick into high gear. When the challenge is over, all systems return to normal and we often feel a lingering sense of accomplishment, which feeds our belief that we can master similar challenges in the future. But it does require a balance in sympathetic and parasympathetic nervous systems. The nervous system that is balanced adapts to a one-time trauma and recovers.
Under chronic stress or trauma, however, the nervous system does not adapt. When the body’s stress response stays on high alert for too long, the systems that were put off-line to support a temporary situation stay off-line longer than is healthy. Depending on the developmental period the brain is in, this can lead to a host of physical- and mental-health issues and a lifelong pattern of emotional self-regulation problems. By undermining the brain’s ability to properly process emotional responses, chronic stress in childhood can have a profound effect on a person’s future resilience.
“Experiencing chronic, unpredictable toxic stress in childhood predisposes us to a constellation of chronic conditions in adulthood.”
The Traumatized Brain
Remember the woman in our opening example? Why the inconsistencies in her memory of the event?
During trauma, the body releases hormones including cortisol and adrenaline. Each affects memory directly but very differently: adrenaline enhances the function of the amygdala—a part of the brain that’s central to laying down emotional memory; but cortisol inhibits the function of the hippocampus, decreasing the brain’s ability to organize and encode those memories. Endorphins are also released, functioning as opiates to help numb physical and emotional pain, while catecholamines interfere with rational thought.
Results of this hormonal dump can remain physically imprinted on the brain long after the traumatic events have passed. This affects three important brain networks in particular: the default network (which helps us process memories, thoughts about the future, what we’re feeling inside, etc.), the salience network (which tells us what we most need to pay attention to in our environment), and the central executive network (which helps us plan, think, concentrate and problem-solve).
After being exposed to a generous helping of this hormone soup, trauma victims may display outward signs that can be confusing to observers with preconceived notions about trauma. For instance, victims may not appear emotionally upset thanks to the numbing action of endorphins. They may have difficulty recalling events and relating them in order. Some of the actions they do relate may seem illogical, thanks to the effect of catecholamines. In fact, if the freeze response kicked in and they became immobile (a common and often uncontrollable reaction), an observer might wrongly conclude that the survivor was a passive or even consensual partner in the event. Further, a trauma victim may show confusion about an event’s less crucial details, though important facts, such as the identity of central figures, will be well imprinted.
This holds true across decades of research looking at all kinds of trauma victims. Yet police officers are often as unaware as anyone else of these common trauma reactions. As a result, men or women who have been sexually assaulted, for instance—and who dare to come forward—are often retraumatized when they’re grilled and cross-examined by law enforcement, or when their story becomes media fodder. This serves as a deterrent to other assault victims, who will be far less likely to report their own experience anytime soon. And of course, the longer one keeps a secret, the harder it can be to share it.
The upshot is that the characteristic reactions of trauma survivors are often the very reasons people don’t believe their stories. While the brain’s reaction to trauma follows predictable patterns, differing levels of resilience can mask this fact. That’s why two people experiencing the same trauma may have completely different capacities for coping.
Fortunately trauma victims can rewire their brains for more resilience. For this to happen, however, each of us must make a conscious choice to rewire our own brain for more compassion. Understanding how trauma can affect people takes us one step closer to that goal.