Post Traumatic Stress Disorder and the Thalamic/cortical Pause

By Gibson, Rod | ETC.: A Review of General Semantics, Fall 2000 | Go to article overview

Post Traumatic Stress Disorder and the Thalamic/cortical Pause


Gibson, Rod, ETC.: A Review of General Semantics


ROD GIBSON [*]

AS A COUNSELOR and trainee psychotherapist, I've found Korzybski's thalamic/cortical model an excellent introduction to the subject of brain functions, and have used variants on the "thalamic/cortical pause" for treating stress and phobic symptoms.

I ask clients when dealing with a phobic panic to pause and become aware of their physiological responses to their experience. Conscious awareness of an increase in heartbeat, sweating palms, shallow breathing, etc., then paves the way for the question "is my reaction appropriate to the stimulus," or "do I need to become so frightened because I can see a spider in the bath?" The effects of introducing a pause and becoming aware of one's s immediate process can sometimes yield immediate and most impressive results, and I have increasingly become interested in the mechanics of why this should happen.

From "Implicit" to "Explicit" Memory

While studying the effects and treatment of Post Traumatic Stress Disorder (PTSD), I've encountered models of brain function which seem to me to owe something of their origins to Korzybski's original model. Willem Lammers of the Institute for the Application of the Social Sciences (I.A.S.) in Switzerland has for some years been treating PTSD with therapeutic techniques intended to process patients' experiences from "implicit" to "explicit" memory. In PTSD, Lammers found, sufferers experience the full impact of the original traumatic event in the "here and now." A case of PTSD resulting from a patient's experience of a car crash resulted in her constant re-experiencing of the force and sound of the impact. After therapy the patient could clearly remember the sound and fury of the original event, but no longer experienced it in her "here and now." Lammers describes this shift in memory as being from "implicit" (currently experienced) to "explicit" (remembered events). [1]

"Re-living" the Event

Current psychotherapy practice with PTSD clients frequently involves a "re-living" of the traumatic event which allows the patient to process the event into a narrative. PTSD treatment as a whole frequently focuses on some method of processing these memories from the implicit to the explicit memory system. Daniel Goleman quotes the example of child survivors of a playground shooting at a school in Stockton, California, who developed a playground game named after Patrick Purdy, the gunman.

"In ensuing months, the Purdy game spontaneously appeared in the play of (the) boys and girls ... one of the many signs that those seven minutes and their aftermath were seared into the children's memory. ... 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 non-traumatized 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." [2]

The physical brain substrates involved in trauma are neatly described by Joseph LeDoux [3], whose extensive research has identified key brain structures used in information processing. In LeDoux's model, incoming stimuli are received by the amygdala (in the thalamus, a phylogenetically older part of the brain), and the cortex, and are processed by both. However, as the senses are effectively "hard wired" to the thalamus, and signals travel at a finite speed, there is a slight time delay before the cortex has full access to the incoming stimuli. So an archaic fear response is triggered in the thalamus by the presence of something in the bath before the cortex has been able to evaluate the level of actual danger from the spider.

In Danger, "Low Road" Takes Control

LeDoux calls these two processing routes the "high road" and the "low road," and indicates the actual time lag involved could be as little as 20 milliseconds. …

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