The infant brain is not fully developed and continues to mature long after birth. It lays down new neural networks throughout the life span. Although this growth takes place primarily during the first several years of life, neuroscience has shown that the process continues throughout an individual’s life (Doom et al., 2018). The organization of self in the developing brain of the infant and child occurs within the context of relationships with others. According to Allan Schore (2021), other people act as an external psychobiological regulator of the experience-dependent
growth of an infant’s brain. Humans continue to grow and develop as relational beings in response to and in tandem with the ways that others relate to them. This relational matrix is often disrupted in the presence of a history of trauma. Prolonged relational disruption affects the core of self as well as the neurobiology of self. Studies have shown that childhood experiences, including neglect and traumatic stress, change the biology of the brain and impact the mental health of the growing child (Doom et al., 2018; McEwen, 2020).
Anatomy of the Brain In the service of understanding how the brain itself is affected by trauma, it is useful to examine brain physiology and anatomy. (See Figure 4-1.) A three-dimensional model and easy visual mnemonic can assist clinicians with remembering the brain’s physioanatomy and can be used to provide an explanation of neuroanatomy to clients. It can be found in the palm of a person’s hand (Siegel, 2012). Figure 4-1. Anatomy and Physiology of the Brain
Note . From Western Schools, © 2018.
A useful exercise for the clinician and client is as follows: First, make a fist with the thumb tucked inside. The forearm represents the spinal cord; the wrist then becomes the base of the skull (the brainstem). The fingers themselves represent the cortex (which houses the brain’s cortical structures [cortices], including prefrontal cortex and orbitofrontal cortex). Turn the hand to view the fingernails. The third and fourth fingernails represent the prefrontal and orbitofrontal cortices, areas important in decision making and learning from mistakes. The lower part of the Right Brain/Left Brain Although the brain is essentially made up of three large systems—the brainstem, the limbic system, and the cortex—it also has an important two-sided nature. Broadly, and by no means exclusively, the left hemisphere is more activated during linear, mathematical, concrete tasks, and the right side becomes more activated during creative and intuitive endeavors. The two hemispheres are connected by the corpus callosum, which communicates information The Effects of Trauma on Affect Regulation The ability to regulate affective states becomes severely compromised during and following trauma and may become chronically dysregulated if posttraumatic stress disorder (PTSD) develops. All persons have an optimal arousal range (Ogden & Fisher, 2015), also known as the window of tolerance (see Figure 4-2; Gene-Cos et al., 2016). This range allows the system to process emotions and arousal at various intensities, without disruption in the system’s functioning (Gene-Cos et al., 2016). Activation
palm corresponds to the lower brainstem. Deep inside the closed fist, where the thumb is encased, is the limbic system, where the amygdala and the hippocampus are located. The cerebellum corresponds to the back of the hand, near the wrist. Notice that the orbitofrontal cortex (the two fingernails) is directly in front of the limbic system, thus forming a link between the limbic system and other parts of the brain. For this reason, the orbitofrontal cortex may be deeply involved in feelings and memory and, importantly, attachment (Siegel, 2012). between the right and left hemispheres, and is important for information processing. Put simply (and with the caveat that the situation is not so simple), the left brain is the naming, or linear, brain and the right brain is the intuitive, or creative, brain. This division of functions may further explain the efficacy of eye movement desensitization and reprocessing (EMDR), which employs bilateral stimulation during reprocessing exercises (Schore, 2019b). of arousal and affect can range from high to low and still remain within one’s tolerance zone. With the introduction of trauma, the ability to remain within the tolerance zone is severely compromised. Poor tolerance for any arousal is a common characteristic of traumatized individuals. The middle zone (or window of tolerance) represents a person’s optimum arousal zone; any affect that falls above or below these lines cannot be properly contained or processed. Hyperarousal (affect at the top level of the zone)
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