REEDUCATING THE EMOTIONAL BRAIN



One of the more encouraging findings about PTSD came from a study of Holocaust survivors, about three quarters of whom were found to have active PTSD symptoms even a half century later. The positive finding was that a quarter of the survivors who once had been troubled by such symptoms no longer had them; somehow the natural events of their lives had counteracted the problem. Those who still had the symptoms showed evidence of the catecholamine-related brain changes typical of PTSD—but those who had recovered had no such changes.16 This finding, and others like it, hold out the promise that the brain changes in PTSD are not indelible, and that people can recover from even the most dire emotional imprinting—in short, that the emotional circuitry can be reeducated. The good news, then, is that traumas as profound as those causing PTSD can heal, and that the route to such healing is through relearning.

One way this emotional healing seems to occur spontaneously—at least in children—is through such games as Purdy. These games, played over and over again, let children relive a trauma safely, as play. This allows two avenues for healing: on the one hand, the memory repeats in a context of low anxiety, desensitizing it and allowing a nontraumatized set of responses to become associated with it. Another route to healing is that, in their minds, children can magically give the tragedy another, better outcome: sometimes in playing Purdy, the children kill him, boosting their sense of mastery over that traumatic moment of helplessness.

Games like Purdy are predictable in younger children who have been through such overwhelming violence. These macabre games in traumatized children were first noted by Dr. Lenore Terr, a child psychiatrist in San Francisco.17 She found such games among children in Chowchilla, California—just a little over an hour down the Central Valley from Stockton, where Purdy wreaked such havoc—who in 1973 had been kidnapped as they rode a bus home from a summer day camp. The kidnappers buried the bus, children and all, in an ordeal that lasted twenty-seven hours.

Five years later Terr found the kidnapping still being reenacted in the victims' games. Girls, for example, played symbolic kidnapping games with their Barbie dolls. One girl, who had hated the feeling of other children's urine on her skin as they lay huddled together in terror, washed her Barbie over and over again. Another played Traveling Barbie, in which Barbie travels somewhere—it doesn't matter where—and returns safely, which is the point of the game. A third girl's favorite was a scenario in which the doll is stuck in a hole and suffocates.

While adults who have been through overwhelming trauma can suffer a psychic numbing, blocking out memory of or feeling about the catastrophe, children's psyches often handle it differently. They less often become numb to the trauma, Terr believes, because they use fantasy, play, and daydreams to recall and rethink their ordeals. Such voluntary replays of trauma seem to head off the need for damming them up in potent memories that can later burst through as flashbacks. If the trauma is minor, such as going to the dentist for a filling, just once or twice may be enough. But if it's overwhelming, a child needs endless repetitions, replaying the trauma over and over again in a grim, monotonous ritual.

One way to get at the picture frozen in the amygdala is through art, which itself is a medium of the unconscious. The emotional brain is highly attuned to symbolic meanings and to the mode Freud called the "primary process": the messages of metaphor, story, myth, the arts. This avenue is often used in treating traumatized children. Sometimes art can open the way for children to talk about a moment of horror that they would not dare speak of otherwise.

Spencer Eth, the Los Angeles child psychiatrist who specializes in treating such children, tells of a five-year-old boy who had been kidnapped with his mother by her ex-lover. The man brought them to a motel room, where he ordered the boy to hide under a blanket while he beat the mother to death. The boy was, understandably, reluctant to talk with Eth about the mayhem he had heard and seen while underneath the blanket. So Eth asked him to draw a picture—any picture.

The drawing was of a race-car driver who had a strikingly large pair of eyes, Eth recalls. The huge eyes Eth took to refer to the boy's own daring in peeking at the killer. Such hidden references to the traumatic scene almost always appear in the artwork of traumatized children; Eth has made having such children draw a picture the opening gambit in therapy. The potent memories that preoccupy them intrude in their art just as in their thoughts. Beyond that, the act of drawing is itself therapeutic, beginning the process of mastering the trauma.

 


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