Introducing trauma

We need to take a statement so we can establish what happened on Saturday night. What time did you get back to David’s flat? What time? I don’t know. Can you give us an estimate? I don’t remember. Would your pals remember what time you left the club? He seemed nice.

She didn’t remember much did she. I know. I know we’ve got to waste more time on a daft lecture. We know how we deal with victims. We’ve had years of experience. Well some of us have had more years than others. I’m in my prime, I’ll have you know. That will be right.

Today’s session is about trauma. The latest in brain science will help you in your work. I’ll start with a tour of the parts of the human brain. The reptilian brain maintains basic bodily functions. The limbic system is also instinctive. It deals with fear and pleasure. For example, you pat a dog, it senses pleasure, and without thinking, wags its tail. The neocortex is the sight of logic, imagination, planning, and control. It’s more sophisticated. But because it’s conscious, it’s slower than the older parts of the brain. The amygdala is a key part of the limbic system. It has one job, to sense danger and set off the alarm. When it’s a matter of survival.

The primitive parts of the brain override the conscious part. There are three possible survival responses, fight, flight, or the one that people don’t think of, freeze. When the alarm goes off, blood and oxygen are diverted to muscles, adrenaline floods the body, and all systems that are not crucial to survival are switched off. Normally, the job of the hippocampus is to file memories so you can retrieve them later. But in times of danger, it stops filing memories. Which makes it harder to gather evidence later on. Instead, the hippocampus switches to pumping cortisone. What’s useful about cortisol, is it stops us feeling pain, so we can focus on survival. Can anyone give me an example?

A farming accident where a man carried his own arm for a mile without feeling any pain. Yes. Excellent example. It is an evolutionary safety mechanism which is fast and instinctive. In essence, it’s our bodies very clever way of protecting us. To recap, an example of the three parts of the brain working together. You’re standing at a bar. Your reptilian brain is keeping your heart beating. You’re enjoying the pleasure of a nice pint with your limbic system. You’re using your neocortex to work out if there’s time for another before the last train. What could happen to make the amygdala kick in? What if this happened? The way you’d respond would depend not on your logical brain, but on your instinctive brain.

Being glassed in a bar would be a traumatic experience. Who can give me another example of an event that can cause trauma? War. Rape. A car crash. Good, yes. Trauma occurs when a person is overwhelmed by something beyond their control. The survival brain takes over the rational brain. It can lead to post-traumatic stress disorder, PTSD, with symptoms that last at least a month. Vicarious or secondary trauma is something you may experience. If you deal with incidents such as rape or sudden death or think of Lockerbie, Dunblane. You are not super heroes. Having a brain makes you all vulnerable to secondary trauma.

It’s important to understand that when trauma occurs again and again, it can become complex PTSD, such as in domestic abuse or child sexual abuse. The alarm system in the brain becomes jammed. Memories are stuck in the limbic system. So a trigger can set off the alarm. The trigger could be anything, a colour, a smell, a sound, a sensation. Now, the indicators of trauma. What should you be looking out for? Depression. Crying a lot. Yes, that’s one response. And at the other end of the spectrum, total numbness. Nightmares, flashbacks. Stress. Good. Yes. And they may feel sick. Also, shame, feelings of guilt, inability to enjoy sex, social isolation, triggers. People often feel overwhelmed by the symptoms of trauma.

This can lead to using alcohol or other drugs to block out memories, or self-harm, or dissociation when a person’s mind detaches from reality. Indicators can be specific to the type of trauma. Say, dental problems, when someone who was orally abused avoids going to the dentist. A victim of abuse might bond strongly to her abuser. This is known as traumatic bonding or Stockholm syndrome. And jumbled up memory, when a person’s normal recording of memories doesn’t work. Can you recall any times you’ve seen that symptom? What time? I don’t know. A traumatised person may not seem like her usual self, or maybe hyper-vigilant, on edge, or being startled by everyday things.

Everyone is different. You never know what impact trauma will have. Symptoms can change from day to day. So what does all this mean, in practise, in your job? A traumatised person’s brain is protecting them. But that normal human response of self-protection can get in the way of evidence gathering. The US military has developed new trauma informed interviewing techniques that you can use to work around this. Research shows that if someone seems vacant, they could be distracted by their traumatic memories. Try to ground them by asking a simple non-patronizing question. Such as, are you thirsty? Do you want a glass of water? This can help bring them back to the here and now. Don’t expect a logical, linear story.

Ask what can you recall just now. Find out what the victim physically felt or saw. Working this way, from the instinctive sensory parts towards the logical parts of the brain, you’ll get more results. In conclusion, four things for you to take away. Trauma response is the brain in survival mode. Repeated abuse can make trauma symptoms worse. In response to trauma, people will behave in unexpected ways. Remember, trauma is a normal human response to abnormal events.

We know that you’ve gone through a really painful experience. But we need to take a statement to understand what happened on Saturday night. Are you able to tell us anything that you remember about his flat? Anything at all? A dog barking. Are you able to remember any physical sensations or feelings that you had? Cigarette smoke. I can smell it now.

What was going through your mind? I couldn’t understand it. I just couldn’t move or even scream. To freeze is a perfectly normal response.

So you start with the memories. You don’t start at the beginning. You have to engage their feelings to get to the facts. Makes sense. Check you, professor, getting all sciency on us. Well, if it gets us usable evidence. There’s life in the old dog yet. Aye.