Yaiza Cabrera: "Our brain has the capacity to heal traumas"

If we are what we are, it is thanks to our ability to remember. Memories are what shapes our own identity and what allows us to distinguish ourselves as individuals, but yes, in the Most of the time, they do not work under our orders, but rather act autonomously beyond what we want in each case. moment.

Traumas are an example of the extent to which memory conditions our behaviors and our emotions for good and bad. Fortunately, this kind of psychological alterations can be treated in therapy, and for this reason, on this occasion, we interviewed an expert in this field, the psychologist Yaiza Cabrera.

• Related article: "Post Traumatic Stress Disorder: Causes and Symptoms"

Interview with Yaiza Cabrera: this is how traumas work

Yaiza Cabrera She is an expert psychologist in the treatment of anxiety disorders and trauma, working with patients of all ages. In this interview, he talks to us about the logics on which traumas work and appear.

What is a trauma, and how is it related to the functioning of memory?

A trauma is an event that threatens the well-being or life of a person, causing consequences in the normal functioning of the subject.

If the emotional charge is strong, the information is stored dysfunctionally, so that it cannot be processed like normal situations, it is In other words, it does not just remain as an experience of the past and for this reason it can be updated in the form of memories and intrusive images when it comes to a simple trauma, or negative thoughts that are triggered unconsciously and give rise to inappropriate reactions and behaviors in the trauma complex.

For example, when we talk about Post Traumatic Stress Disorder (PTSD) we find that, according to the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5), one of the criteria to know if a person suffers from PTSD is the inability to remember relevant aspects of the event traumatic.

We can define this as dissociative amnesia, and although the memories seem not to be stored, these can modify the behavior of the person without being aware of the reason for it.

People who have suffered a traumatic experience may have nightmares, intrusive memories, or flashbacks. That is to say, there are parts that you may have forgotten due to that dissociative amnesia, commented on in lines but there may also be other details or scenes that come back to mind in a very vivid. These re-experiences are uncontrollable and inevitable for the person who suffers them.

To better understand this, it is necessary to differentiate intrusive memories from flashbacks. The first ones are memories, while the second ones are not memories as such, but are images where there is no temporality, that is, the person has the sensation of seeing everything new.

This arises in the presence of stimuli that have nothing to do with the traumatic situation. For example, a person is involved in a robbery at a gas station whose counter is yellow. Some time later this person may be walking in the park and see someone in a yellow shirt and this may be a stimulus that triggers the flashback. Another example is the military who have attended conflicts and then present said flashbacks before the flyers at a party.

For this reason, flashbacks are not just a memory of a distressing experience, but we refer to the feeling of re-experiencing that traumatic experience and thinking that everything is happening again new.

Another effect on memory is that there is a disorganization of it, fragmentation of memories or total or partial forgetfulness.

The type of memory that seems to have the most relationship with trauma is autobiographical memory. This type of memory allows us to remember the events of our life and our environment. Thanks to it we can have a coherent discourse of our life history.

However, the memory of the trauma is not a coherent story as are the memories of the autobiographical memory. Well, studies suggest that the problem may occur in this memory system.

Therefore, as previously mentioned, the memory of the trauma is fragmented and even seems to be separated from the person's life history. As these memories are out of their control, the person feels them in an invasive and intrusive way with respect to autobiographical memory.

As already mentioned, memory processes for traumatic events are different than for ordinary events. Some of these differences are as follows.

In the first place, traumatic memories have a more complicated recovery, with parts stored outside of consciousness and where the so-called flashbacks occur. They are evoked automatically and uncontrollably by cues that act as triggers (for example, the yellow shirt the guy in the robbery saw at the gas station).

On the other hand, in ordinary memories (memories that are not of traumatic experiences) recovery is easy and consistent. In addition, its evocation is voluntary and conscious. The person can control them (unlike flashbacks).

The longer you have been living the experience, the more likely you are to retrieve that memory. But if a lot of time has passed, it will be more difficult for you to recover it. In addition, they are very malleable and can be adapted as time goes by.

Therefore, in general, we can say that a traumatic experience with a strong stress component can influence the way information is encoded, stored, and retrieved.

Why is childhood considered a key stage of life in which traumas can affect us especially?

It is important to take into account the development of the child's brain. A child has not yet developed its brain and the storage and retrieval of events is not the same as that of an adult. For example, when faced with a painful event that is difficult to process and understand, the child does not store the information or organizes it in memory in a coherent and orderly manner, but does so by fragments.

The child may undergo a dissociation process that makes it difficult for them to be able to situate themselves itself and events over time, as well as to organize stored information and get it back

For example, a child experiences a violent episode as a spectator in which his father hits his mother and this child undergoes a dissociation process in which his brain escapes to protect him. This process is somewhat protective for the minor, but it takes its toll when they are adults, protecting themselves from a danger that no longer exists.

As we said before, a child who has suffered trauma and presents a dissociation stores the information in a fragmented way, as if it were recorded in his mind. on the one hand, a film of what happened, of the facts, which would be the declarative memory, and on the other, the sensations and emotions, which would be the memory implied.

What happens is that the new information that the child has to process is organized and structured by comparing and organizing it into in relation to the previous information in memory and when it recovers the information if it is fragmented it is recovered like this, so fragmented.

In addition to this, children suffer as a consequence of the trauma conditions in terms of their linguistic and cognitive level. It also happens that both the sequence of the story and the cause-effect relationship are often affected and it is difficult for them to identify the way in which one thing leads to the other.

On the other hand, children learn to regulate their emotions and therefore to be able to face painful events through their attachment figures that provide them with that security and trust.

They need those links to be able to trust and not perceive the world in a hostile and dangerous way. Well, if we interrupt this regulation process (for example; death of parents with no other attachment figures available), or there is simply no interruption but there was never that secure attachment figure, what will happen to this developing brain? child? Well, probably that healthy emotional regulation that leads him to be a self-confident adult is not generated, but he will try to manage the emotions of him alone, without reference to security, and the world becomes chaotic, hostile and distrustful, and this development does not reach occur.

For example, a small child who spends his childhood in juvenile centers and above all, if for whatever reason, he goes changing homes, you will have that feeling of abandonment, you will not generate that healthy emotional regulation that was indicated in lines previous. His brain is modified on both a functional and structural level. In fact, many children who have suffered constant abandonment situations during their childhood have a smaller hippocampus.

Growing up these children have trouble maintaining trusting relationships because they have internalized this feeling of abandonment.

A child who has not experienced this and his brain develops in a safe environment is evidently not safe from painful events happening to him in the future, such as a couple breakup, but his brain is better prepared to process it without being carried away by dysfunctional beliefs such as "nobody loves me", "I'm not worth enough for someone wants to be with me”, etc., while the other child, who did not have this development, will live it in a more painful way because the erroneous beliefs that he learned in his life are activated. childhood.

Children are not born with their brains fully developed; there are aspects that develop through throughout his life and which depend a lot on the environment of the minor and the stimulation that receive.

In short, the child's brain is not prepared to suffer certain events and the worst thing is that some bases will be established that will generalize to other areas in the adult stage.

What are the types of traumas that exist, and their symptoms?

We could say that there are two types of traumas. Simple trauma and complex trauma. Simple trauma is a specific situation in which the person sees their physical or emotional safety at risk, such as an accident, a robbery, a catastrophe, an attack, a serious diagnosis, the death of a loved one or even witnessing one of these circumstances up close (vicarious trauma).

Although, sometimes this is just the trigger of a complex trauma that we carry from childhood.

On the other hand, complex trauma is due to a nurturing environment of neglect and abandonment by the person's most significant caregivers. It can even occur even if there is no negligence, but rather due to a constant transmission of negative and/or derogatory messages that a priori may not seem to do harm. but that remain burned into the memory of that child, influencing his way of thinking, his self-esteem and the attachment and relationship needs that he may have adult.

This type of trauma remains stored in the psychic apparatus and in the neurobiological system as an implicit memory that can be experienced in sensations. somatic (for example, ulcers, irritable bowel syndrome) and negative thoughts and emotions that are triggered unconsciously and lead to reactions and behaviors inappropriate.

The severity of the adult sequelae will depend on how long that situation has been maintained. negative, how intense the situation has been and at what age, among other variables, began the negligence.

As a psychologist, have you seen cases where the symptoms of trauma have taken a long time to appear since the traumatic experience occurred?

Yes, for example, I remember a case where the person came for a duel. I worked with her from the EMDR technique and we reached the death of her mother. She passed away when she was barely 9 years old. It was in a car accident where she was also going. The nuance is that she was in a coma and by the time they can tell her what happened, her mother is already buried and she had already gone through the entire wake process. So she can't say goodbye, she can't go through the grieving process. In reality, the death, also unexpected, of her friend (which is why she came for consultation), acts there as a trigger for the symptoms of trauma and it is at this moment when the person lives those symptoms.

Above all, it can occur with the traumas that we previously called simple. If, for example, one day as a child I went to the zoo and a monkey attacked me, I can develop a phobia and from there generalize this fear to all monkeys or even to all wild animals. It may happen that I don't come back and therefore there are no symptoms and I have a normal life, but one day, adult, I decide to take my children to the zoo and when I see a monkey I start to relive that experience traumatic Here I am living the symptoms of an unresolved trauma.

However, in reality, most of the time the symptoms of a trauma are experienced during the entire process, although later there is a fact that triggers the gross symptoms by calling it something.

For example, a person may have suffered some type of sexual abuse such as touching by a adult and she doesn't understand what was happening but she shuts him up because she tells him that it's a secret game between they. There are symptoms that will be in your day, which are due to erroneous beliefs learned there, such as "it is better to keep quiet" (submissive person, with low self-esteem, etc.) but However, when this person has their first sexual relationship is when the symptoms that we previously called gross will appear (anxiety, fear, rejection, disgust, etc.)

Does the fact of having developed a trauma make people more vulnerable to the possibility of living more traumatic experiences? For example, tending to get involved in toxic partner relationships.

It depends a lot on each case and on the help that the person has had with that trauma. But it is true that when a person has developed a trauma, let's say that he does not have the same tools to face the world, and that includes many aspects such as work life and couple life. They are more likely to suffer harassment at work or have toxic relationships developing emotional dependence.

This happens especially with the type of trauma that we defined at the beginning as complex trauma. For example, if we have had emotional deficiencies in childhood, we may tend to look for situations like the following.

On the one hand, dependent relationships, where the love and attention of the other person will never be enough. We will never feel that this love pleases us and fills us completely because that's how I learned it in my childhood. I couldn't cover that need at the time.

It is as if, in a certain way, I seek to corroborate my idea of ​​"I do not deserve love" or "I do not deserve to be loved", and therefore I tend to look for people who do not commit themselves. never and that they finally end up breaking the relationship confirming my idea of ​​not deserving to be loved, or repeating the story of emotional abandonment that I have experienced always.

On the other, non-reciprocal relationships. I will tend to take a submissive role in the relationship because I believe that the only way to keep someone by my side is to please them in everything. And for fear of a new abandonment I do everything the other wants.

Therefore, these people are "armed" with very dysfunctional beliefs that make them vulnerable to suffering traumatic events again. For example, a person who has a very internalized belief about himself that "it is not safe to express my emotions" because what he experienced in his childhood was that every time he tried to express himself he received punishment, he will tend to keep quiet, never say no, because he feels more secure So. So, who will be more likely to suffer, for example, workplace bullying?

The person who already comes with this belief and is silent before anything that is asked of him, even if he seems unfair, or the one who believes that he can freely express his emotions and that nothing happens for it?

Obviously, those who come with this belief that it is not safe to express their emotions are more vulnerable to suffering workplace harassment, getting into toxic relationships, etc.

In fact, it is not uncommon to hear patients say that they have had very bad luck with their jobs because there has always been a very bad environment and they have taken advantage of it.

This is not coincidence nor is it bad luck, it is the person's dysfunctional beliefs, generated by that trauma, which make them behave in a certain way as it is by doing everything they ask for at work, even if it means doing overtime that no one is going to pay me pay. Of course, it is not the patient's fault either, but it is true that he is more prone to it because he is "unarmed" to face according to what situations or because they have been taught throughout their lives the "wrong tools for such situations”.

The good news in all this is that just as you learned a series of dysfunctional habits and beliefs about yourself, you can unlearn them and learn more functional and adaptive ones.

What can be done from psychotherapy to help people with traumas?

A widely used technique in these cases is EMDR, whose acronym stands for Eye Movement. Desensitization and Reprocessing, in Spanish, Desensitization and Reprocessing through Eye movements.

This is a psychotherapeutic approach to treat emotional difficulties caused by difficult life experiences, such as workplace bullying, phobias, panic attacks, traumatic death and grief or traumatic events in childhood, accidents, natural disasters, etc

It consists of the processing of said experiences through procedures that include eye movements or other forms of bilateral stimulation, such as auditory or tactile stimulation. This may seem like something magical to us, but it is really science, it is neurological, our brain has that ability to heal traumas.

This stimulation facilitates the connection between the two cerebral hemispheres, allowing information to be processed and the intensity of emotion to decrease.

During the process the patient describes the traumatic incident. The psychologist will help you select the most important and distressing aspects of the incident. As the patient makes eye movements (or any other bilateral stimulation) other parts of the traumatic memory or other memories come to mind.

The objective is for the patient to process the information about the traumatic incident, making him more adaptive, that is: having fewer symptoms; change the negative thoughts he had about himself regarding the incident (for example, a very frequent one is “it's my fault, I'm guilty, I should have done something to avoid it); and be able to function better in everyday life.

The results are good, especially because it works on the patient's past, that is, you come to see a problem of workplace bullying, for example, but then processing this fact your brain can connect with other older memories where the bodily sensation, or the emotion or the thought was the same as you have now. Then it works well because it is like going to the root of the problem (obviously it is not always in childhood but it does happen frequently).

Sometimes we focus only on the present, on the symptoms that the person has, but we do not go further and this is like applying patches, it works for me because I have learned techniques to control it, but by continuing to have the root of the problem, it is enough for another stressful situation to occur that overwhelms me for those patches to pop up and the symptoms return from new.

The course of the processing depends a lot on the patient because there are patients who get blocked and after the processing nothing ever comes to them, that is, they have no other images of that incident or of other past ones, the emotion they felt at the beginning has not changed for the better or for the worse (because here a nuance should be made, the fact that The fact that negative memories or sensations come to the patient during processing does not mean that it does not work, quite the contrary, that brain is processing the information).

Well, these patients are not processing, they are blocked, but usually it is because of some negative belief they have about themselves that prevents them from continuing. For example, a very frequent one is "I cannot express my emotions", with which they feel afraid when it comes to say what comes after the processing because they don't feel safe, they don't know if they are doing the right thing saying what feel. That is why in these cases it is necessary to first identify what those beliefs are in order to see where they come from, and unblock them, and thus be able to continue processing without blocking.