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TRAUMA (cont.)

Trauma - part 2

I see many patients with this combination of complaints: anxiety, depression and poor sleep. On deeper questioning, they usually begin by saying their complaints are not due to any particular  event, but just due to “life in general.” But occasionally something is remembered - a traumatic event pulled up from deep in the recesses of their repressed memory. The trauma they recall could be anything from the death of a close friend or family member, to childhood physical, emotional or sexual abuse. Recently it is understood that the way the brain processes information actually changes during an attack or traumatic event. When “fear circuitry” kicks in, the prefrontal cortex plays less of a role in processing traumatic data as opposed to more “normal” experiences. This is a protective mechanism designed for the brain to efficitnyl access learned protective responses when danger is perceived. This is why memories of certain traumatic events, particular sexual assault are often cloudy and peripheral memories, such as the music playing or furniture in the room, may be more clearly remembered than the actual events. These peripheral memories may then become “triggers”for anxiety. panic attacks and nightmares.

Anxiety and depression can result from lack of control over these unpleasant responses to stressful triggers. Talk therapy focuses on cognitively understanding the traumatic event and it’s effects the brain and memories.Medication can help to diminish the symptoms but obviously cannot “change” memory. If anxiety can be reduced, understanding one’s past can be facilitated.

When faced with a  patient or client with anxiety, depression, sleep problems and general lack of well being, I have found that thoughtful questioning often results in the patient gaining insights into how events of the past can have profound effects on quality of life in the present.

In health,

Dr. John Monaco

MONACO Wellness


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