Tag Archives: trauma

Cognitive Trauma: What you need to know

Cognitive trauma in relation to brain impairment is not something that is greatly known, due to its diminishing characteristics that create deep-rooted effects. However, in recent years there has been more and more research conducted that indeed reveals insight into this neuropsychological dilemma. This article, in particular, will outline the whole idea revolving around cognitive trauma in neuropsychology, what is cognitive trauma, effects of cognitive trauma, problems derived from cognitive trauma, tips on dealing with cognitive trauma.

Introduction to Cognitive Trauma

Cognitive Trauma: Traumatic Brain Injuries (TBI)

What is a Traumatic Brain Injury?

The neuropsychology field turns to be flooded with cognitive development in regards to traumatic brain injuries. As stated in the Cambridge University Press, “well-recovered individuals who had sustained a minor trauma more than half a decade ago continue to have long-term cognitive sequelae relevant for everyday social and professional life” (Konrad et al, 2011, p. 1197). Such concealed, and yet evident findings into cognitive trauma and traumatic brain injuries (TBI) help gain insight from various doctors and in return use it as a primary source to represent the development across the field. On the other hand, many doctors find the information revolving around cognitive trauma conditions to be minimal. As sometimes the determination of whether or not permanent brain withdrawal is present can be unsubstantial.

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There is a rising occurrence of TBI’s and cognitive trauma in military personnel, and they are also becoming more prominent in the war zone and terrorist attack victims too (Risdall & Menon, 2011). Traumatic brain injuries, in particular, are something that happens due to direct contact with the head, often causing some type of cognitive trauma. For instance, something such as an accident or explosion could result in a blow to the head developing the potential for cognitive trauma in an individual. This is particularly prevalent in military personnel within war zones due to the constant turmoil and upheaval occurring around them. However, it’s the symptoms that follow a TBI that can be particularly uncomfortable and challenging. When faced with this adversity certain things such as cognitive trauma conditions can start to play a part. The big question that many people often want to know now is whether traumatic brain injuries can directly cause cognitive trauma conditions? Without the slightest doubt, cognitive trauma conditions are quite prevalent in some cases specifically in military war conditions. “TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that have been called the polytrauma clinical triad” (Risdall & Menon, 2011, p. 241).

Cognitive Trauma: Effects of Traumatic Brain Injuries (TBI)

First and foremost, after a TBI instance occurs an individual needs to be checked out immediately by an appropriate professional health care provider to determine the course of treatment. This is something that many patients are unaware of, as a TBI requires additional treatment after the incident that most likely will be needed for the remainder of the patient’s lifetime. The typical approach for treatment post TBI involves a bold approach of ICP monitoring for serious cases, where it scientifically increases the overall result of recovery and diminishment of overall cognitive trauma (Stein, Georgoff, Meghan, Mirza & El Falaky, 2010). A brain injury and cognitive trauma coinciding is something that can really impact an individual for the rest of their life. Between managing the symptoms and dealing with treatment and recovery it can be a hard feat. Managing symptoms is a big task alongside treatment, which can become overwhelming with the numerous courses of rehabilitation. Yet, it’s the alternative treatments that are limited and need to be expanded upon through research. As research into new treatment methods can help provide more sound reasoning into the appropriate ways certain methods can make a difference in cognitive trauma and TBI’s.

Cognitive Trauma: Problems after Traumatic Brain Injuries (TBI)

The most prevalent problems associated with cognitive trauma and TBI consist of:

When an individual experiences a TBI there can often be cognitive problems that arise as a result, due to the injury. Initially one must understand what cognition is in order to explore further, cognition is often described as the thought of knowing. The different types of cognition that will be explored are areas such as, info processing, communication, reasoning, concentration, memory, and control.

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It is important to keep in mind that there are many different aspects of cognition, but for the sake of how TBI’s can affect cognition these will be specifically addressed. When an individual has a TBI it is often the after effects that cause the most issues, this is where info processing takes a hit. Following a TBI one’s potential to process something decreases substantially influencing reaction time and other similar avenues. Communication is another dilemma that is faced for victims of TBI’s creating adversity with all things in connection to asserting and comprehending the material.

On top of these two issues is also the halt in concentration making the need to focus a thing of the past. Control and reasoning are another plaguing problems often going hand in hand with one another. Where brash choices are made often due to the lack of being able to identify issues in the first place. It is important to note that not all these problems will occur for every individual that presents with a TBI. Nonetheless, when issues arise it is key to report them to a health care professional to ensure the appropriate treatment measures.

Cognitive Trauma: Current Traumatic Brain Injury (TBI) Studies

The research that has been done on cognitive trauma relating to TBI’s is relatively sparse and has left a great amount of room for improvement. Initially, a large amount of research that has already been conducted focuses more on cells and sham control for treatment on one end or MRI evaluation on the other.

There was a study conducted by a handful of doctors on cell study in TBI patients properly examined intracerebral effects while also delving into the intravenous application of bone marrow stromal cells (MSCs) with endogenous cellular proliferation following a TBI (Mahmood, Lu & Chopp, 2004). Following, the results that have been discovered are not always conclusive and tend to create some conflicting ideas. It was discovered that that through the proper study of rats this treatment of TBI proved to be successful. Successive TBI in rat subjects established that intracerebral and intravenous MSC dispensation improves endogenous cellular proliferation (Mahmood, Lu & Chopp, 2004, p. 1185).

However, other types of research done found that the results are not an immediate reaction but something that occurs only with the duration of time. In a six month investigative cycle, there was no instantaneous or slowed harmfulness affiliated with cell application. Additionally, not all studies deal with human patients, which makes for insufficient discoveries. Due to the fact that most of the studies conducted have for the most part been done on rat subjects and not all on human subjects, which creates room for error. Lastly, not all aspects of the matter regarding cell study in regards to TBI and cognitive trauma have been fully analyzed.

Cognitive Trauma: The incidence of Cognitive Trauma and Traumatic Brain Injuries (TBI)

The overall incidence of cognitive trauma and TBI is only multiplying year after year (Dulac, Lassonde & Sarnat, 2013,p. 891). As behavioral limitations evolve it creates something that all individuals suffering from TBI’s and cognitive trauma misjudge. People that have TBI or cognitive trauma at first don’t always evaluate their situation entirely which creates instances where social situations involving emotions and interactions are turned for a loop. The main cause of this particular issue is due to the alterations that have occurred in “hippocampal, prefrontal cortical, and limbic region function because of alterations in synaptogenesis, dendritic remodeling, and neurogenesis” (Kaplan, Vasterling & Vedak, 2010, p. 427). After a brain injury has occurred various behavioral disorders such as self-awareness become quite prominent. If the frontal lobes of the brain are the source of the TBI a relation between behavioral changes is usually relevant.

Cognitive Trauma: Necessary Development of Research

The various accounts of information that were the result of studies conducted provided some very good insight into the matter. Such concealed, and yet evident findings in traumatic brain injuries (TBI) and also cognitive trauma help gain insight from various doctors and in return use it as a primary source to represent the development across the field. Contrary to all the information that was a gained, the way that individual deals with the instance of a TBI or cognitive trauma are going to be different for each individual.

This research and more and more research adventures down the road are going to open new doors into this field and create a whole new amount of knowledge. Disappointing conclusions are due to the absence of accurate result amounts mingled with the heterogeneity of TBI (Yue et al, 2013). Despite the various efforts over the years to help people with TBI’s and cognitive trauma, more research is without a doubt needed. Over the course of the past 30 years, existing methods into the classification of condition seriousness have yet to evolve (Yue et al, 2013). That being so it creates a necessity to develop new studies so that research can be advanced in a positive direction. This will ultimately help individuals with the strongest effects of TBI and cognitive trauma to help ease the fallbacks of current treatment methods.

Cognitive Trauma Tips

Tips for Dealing with Cognitive Trauma

Learning to live with cognitive trauma is not an easy feat, and hopefully, through useful methods, individuals can cope. One of the most important things that anyone who is suffering from cognitive trauma can do for themselves is seeking out the care of a professional. Through this different types of treatment methods can be discussed leading towards a positive recovery approach. When someone is suffering from cognitive trauma,  one of the most common therapy approaches is cognitive behavioral therapy (CBT). Through CBT there are beneficial approaches that can be made to help treat an individual who suffers from cognitive trauma.

 

References

Dulac, O., Lassonde, M., & Sarnat, H. B. (2013). Traumatic brain injury. Pediatric Neurology, 112, 891.

Kaplan, G. B., Vasterling, J. J., & Vedak, P. C. (2010). Brain-derived neurotrophic factor in traumatic brain injury, post-traumatic stress disorder, and their comorbid conditions: role in pathogenesis and treatment. Behavioural pharmacology, 21(5-6), 427-437.

Konrad, C., Geburek, A. J., Rist, F., Blumenroth, H., Fischer, B., Husstedt, I., … &  Lohmann, H. (2011). Long-term cognitive and emotional consequences of mild traumatic brain injury. Psychological medicine, 41(6), 1197-1211.       

Mahmood, A., Lu, D., & Chopp, M. (2004). Marrow stromal cell transplantation after traumatic brain injury promotes cellular proliferation within the brain. Neurosurgery, 55(5), 1185-1193.

Parker, R. S. (2012). Traumatic brain injury and neuropsychological impairment: Sensorimotor, cognitive, emotional, and adaptive problems of children and adults. Springer Science & Business Media.

Risdall, J. E., & Menon, D. K. (2011). Traumatic brain injury. Philosophical Transactions of the  Royal Society of London B: Biological Sciences, 366(1562), 241-250.

Stein, S. C., Georgoff, P., Meghan, S., Mirza, K. L., & El Falaky, O. M. (2010). Relationship of aggressive monitoring and treatment to improved outcomes in severe traumatic brain injury. Journal of neurosurgery, 112(5), 1105-1112.

Yue, J. K., Vassar, M. J., Lingsma, H. F., Cooper, S. R., Okonkwo, D. O., Valadka, A. B., … & Puccio, A. M. (2013). Transforming research and clinical knowledge in traumatic brain injury pilot: multicenter implementation of the common data elements for traumatic brain injury. Journal of neurotrauma, 30(22), 1831-1844.

Zhang, Z. X., Guan, L. X., Zhang, K., Zhang, Q., & Dai, L. J. (2008). A combined procedure to deliver autologous mesenchymal stromal cells to patients with traumatic brain injury. Cytotherapy, 10(2), 134-139.

Emotional blockage: What is it and how to overcome it?

Have you ever felt so nervous about an important situation that you couldn’t react? The words aren’t coming out of your mouth? Felt paralyzed? Have you felt like you can’t get over some aspect of your life? Do you feel trapped or that there is no way out? Maybe you might have an emotional blockage. Find out what is an emotional blockage, its symptoms, functions, treatments, and more.

Emotional blockage

Emotional blockage and emotions

Emotions are part of us and are a response of our physiological system to situations or events both internal and external. All human beings experience emotions, in greater or lesser intensity and in a more adjusted or less adjusted way. Emotions affect our learning, motivation, behavior and communication with others.

When we are born we already have a wide range of experience and emotional expression called innate emotions. Among these are joy, sadness, anger, and disgust.

Based on these innate emotions and throughout our human experience, we are always broadening our emotional range, including emotions such as guilt, resentment, trust, jealousy. That is why emotional education is so important from an early age, to learn to manage them with the different situations life throws at us. All emotions have their function:

  • Sadness: its function is the withdrawal of oneself in order to assimilate the situation and recover energy to establish changes in the future.
  • Anger: its function is making decisions about the situation or person who may be hurting us, mobilizing energy to change that situation. For example, if our partner has hurt our feelings, we get angry which in turn aids our partner to readjust their behavior so as not to make us feel this way, or it would cause us to move away so that we no longer feel that negative emotion.

What is an emotional blockage?

An emotional blockage is a defense mechanism of our brain that prevents us from feeling emotions normally. It is a very unpleasant feeling that prevents us from moving forward and at the same time prevents us from thinking clearly and affects our daily actions. Not being able to think clearly, not knowing what to say, or being confused can be some indicators of emotional blockage.

Everyone at any given time in their lives has gone through an emotional blockage, and most of the time it is difficult to manage. This emotional blockage does not have to affect all areas of our lives but it may be affecting cognitive skills, emotions, and behavior of a  specific area such as work, friendship, family or love.

Symptoms of an emotional blockage

Signs that we might be experiencing an emotional blockage are:

  • Avoiding people or social situations. For example, avoiding situations because you are scared of how to act or what to say. This is usually linked to situations similar to which generated the emotional blockage in the beginning.
  • Increase in anxiety or stress levels the day before different events.
  • Lack of motivation that lasts for a long time and affects different areas of our lives.
  • Feeling negative emotions with greater intensity than before. For example, feelings like envy, jealousy, criticism, etc.
  • Worrying about different areas.
  • Difficulty making decisions.
Emotional Blockage

Functions of Emotional Blocking

An emotional blockage is activated in certain situations to cushion the impact of a negative situation or event that can be very painful for us.

In reality, it is a defense mechanism to protect our minds from what we might feel in that situation. Therefore, the mechanism blocks part of this emotion, allowing us to continue living with a certain normality in the other areas, and allows us to accept little by little what has happened in order to adjust ourselves again to the situation.

The emotional blockage allows us to take our time to process little by little the negative situation.

On the one hand, an emotional blockage is a positive mechanism because it protects us from something considered “dangerous” by our brain. During the emotional blockage, the person adapts to reality and puts starts putting into practice resources on how to manage the situation. This mechanism helps the person learn to manage other similar situations in the future.

An emotional blockage is activated especially in the event of sudden situations, which could not be foreseen, then the brain to protect itself from the stress that all this entails sets it in motion a cushion for the emotional pain.

Situations that activate an emotional blockage

Situations that trigger this emotional blockage are often negative or traumatic. They are stressful situations that the person is not used to dealing with or has no coping skills for it. For example:

  • Traumatic experience: accident, rape, assault or attack, infidelity.
  • The sudden death of a loved one.
  • Breaking up or loss of a partner.
  • Dismissal or change in employment status.
  • Diagnosis of a serious or chronic illness.
  • Unexpected change of city.

We are not only emotionally blocked by negative events, but also positive. In the face of some good news that we did not expect, we also need some time to get used to the idea and assimilate the news. For example news of a pregnancy, promotion at work, a surprise visit, etc.

Positive changes can also be a shock for us to take in, not only what it would mean for our lives but if our dreams come true, etc.  This emotional blockage is positive in order to gather your thoughts and process what changes might come to your life, whether those are positive or negative.

Is an emotional blockage a problem?

An emotional blockage becomes a problem when it remains over time and begins to affect us in other areas that it didn’t previously. It becomes a problem when it begins to hinder our goals and life dreams.

By prolonging the emotional blockage over time without actually putting the emotional work it takes to process the situation, the person will begin to feel pain without being able to express it. The person will also experience other emotions disproportionately such as anger, sadness or guilt. It starts to become part of our day to day life and the situation starts repeating itself in our minds, affecting our concentration, cognitive skills, emotions and social skills.

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At an extreme level, the emotional blockage can become so intense it can start affecting our physical health, and we start developing diseases. Some diseases are stomach ulcers, gastritis, skin conditions, etc.

The consequences of maintaining an emotional blockage for longer than necessary are:

At the behavioral level

  • Substance addictions (alcohol, antidepressant, etc.), which would worsen the emotional situation.
  • Increased experience of negative emotions at extreme levels such as anger or resentment.
  • Devastating consequences on our self-esteem.
  • Limitation of our social skills (loss of social ties, separation from family and friends, etc).

In our health

  • Psychosomatic illnesses: physical pains and digestive disorders.
  • At a more extreme level, we find stomach ulcers, skin problems, asthma, and colitis.
  • Impairment of the immune system causing especially autoimmune diseases.

Treatment for Emotional Blockage

To overcome an emotional blockage it is advisable to see a therapist. This does not mean that we cannot try it ourselves, but if after some time (it’s different for every situation) the emotional blockage persists it is more advisable to go to a therapist. The therapist will work on regulating our emotional expression in order to unblock the emotional blockage.

The treatment is usually a Cognitive Behavior Therapy focused on both cognitive and emotional level at first, because by improving those levels, as a consequence would also improve behavioral. Behavioral work is sometimes also necessary to speed up the recovery process.

The first step in the therapeutic process will be to become aware of the existence of this emotional blockage and investigate the cause or causes that may have originated it and other events that have been able to maintain and prolong it over time.

Cognitive treatment of the emotional blockage

To work on the emotional blockage, the therapist will try to work on the patient’s cognitive distortions that might be helping maintain it, even if this might be painful.

Adjusting these cognitive distortions help create more effective trains of thought and less painful ones. Many of the distortions found in these cases are about one’s own emotional experience, such as “I have to be strong and strong people are not afraid”. In this case, we would focus on accepting that the belief of being strong is not “the absence of fear”, but adjusting it to reality it would be “despite feeling fear, I will make decisions and assume consequences”.

Emotional treatment of the emotional blockage

On an emotional level, the focus would be on emotional re-education and learn to feel emotions again, both negative and positive.

Emotional self-regulation, emotional expression and evaluating emotional situations are also aspects that the therapist will help us evaluate for further situations.

The therapist will also help us develop greater emotional intelligence and the areas that integrate it.

“The world breaks everyone and afterward many are strong at the broken places.” Ernest Hemingway.

With therapy, you will be able to center your emotions and express them accurately, as well as learn to cope with similar situations avoiding another emotional blockage.

Another important aspect is the capacity to develop empathy, so as to lean on people in case another emotional blockage happens and be able to ask for help.

Behavioral treatment of the emotional blockage

It is not always necessary to work in this area in an emotional blockage, but when it is done it would focus on planning our routine to carry out activities that make us feel positive emotions. Experiencing more positive emotions helps to unblock other emotions, helping us process events better.

The whole process would always be about accepting the traumatic experience, finding a real meaning to it and integrating it into our life story. When we speak of acceptance we refer to accepting the experience as it is, whether it is pleasant or unpleasant, accepting the situation as something natural that is not always under our control.

The patient will learn to see negative experiences not as something horrible to run away from, but as part of what we are going to experience in our lives. Resigning control would make us accept emotional reactions such as crying and experience them as they are, thus being functional.

Have you suffered any emotional blockages? Leave your comment.

This article is originally in Spanish. This translation is done by Alejandra Salazar.

Narrative Exposure Therapy: What’s your story?

A lot of time and resources have been spent on investigating Post Traumatic Stress Disorder (PTSD) in soldiers- and it’s warranted (more on how to live with PTSD). With the constant bombing, fighting, and unavoidable death that surrounds them it is no wonder that people pay attention to soldier’s needs. But there is one huge group of people dealing with the same issues that are not getting the same amount of attention: refugees. As many as 40% of refugees meet the criteria for PTSD because of the prolonged, repeated exposure to trauma. Narrative Exposure Therapy is a fairly new treatment for survivors like these, who are extremely susceptible to PTSD and have suffered through multiple types of trauma.

Narrative Exposure Therapy

There are approximately 21.3 million refugees across the world right now. According to the UN, approximately 34,000 people are displaced every day- that is 34,000 more people facing loss, resettlement, war and torture, and a host of other traumatic experiences every day. Narrative Exposure Therapy is about reconciling those who have gone through that sort of trauma with their life story. With Narrative Exposure Therapy, you piece together a coherent, chronological narrative of your life, focusing on the traumatic events. Those who have a very unstable life, like refugees, often have fragmented, disjointed, memories. The goal of Narrative Exposure Therapy is to transform these disorderly memories into a cohesive story- a testimonial of sorts. This testimony, if you agree, can also be used as evidence when prosecuting humans rights violations or raising awareness about them. While Narrative Exposure Therapy is still an up-and coming therapy, it is supposed to help not only the patient process painful emotions but potentially others suffering from the same injustices as well.

Narrative Exposure Therapy: How it Works

Narrative Exposure Therapy functions under the premise that the more trauma you experience, the larger your fear network is. Your fear network is made up of the emotional memories that are associated with sensory, cognitive, and physiological elements. The larger your fear network is, the more triggers there are that can set off PTSD.

Narrative Exposure Therapy: The NET Model

In Narrative Exposure Therapy, there are two types of memories associated with trauma: hot memories and cold memories. The hot memories are the ones in your fear network: the sensory details, emotions, and physiological reactions to the trauma. For example, if you experienced increased heartbeat and smelled gasoline during the incident, these would be a part of the hot memories and your fear network. Your cold memories are the opposite: they are the facts. Place, date, time of day, the people that were there- these are the sorts of things that your therapist would try and make you remember. According to the Narrative Exposure Therapy model, when you have PTSD, your hot memories are triggered without any reference to the cold ones. By making a chronological autobiography, you link the hot memories to the “cold”, hard facts to solidify and contextualize the trauma. You revisit the traumatic event in a safe environment, this time from the perspective of your entire life, instead of reliving it as a reaction to stress in the present.

Narrative Exposure Therapy: The Lifeline

Lifeline is exactly what it sounds like- a line that describes your life. Taking a birds-eye view of your life allows distance and space to reflect on all the good and bad moments. With a therapist, roll out a long piece of rope, ribbon, or string- one end represents your birth and the other represents your life that is yet to be lived. There are two objects that you lay down to represent different events in your life: stones and flowers. The stones represent shameful, difficult, and especially traumatic memories, and the flowers represent positive ones. This exercise is usually done during the first session because using the lifeline you can plan out which ‘stones’ you want to focus on in your future sessions.

Narrative Exposure Therapy: Going Forward

The lifeline is actually not a mandatory part of Narrative Exposure Therapy but can be helpful. Over your therapy sessions, you can go through the flowers and the stones, taking the time to unpack and sort through the stones. The goal of talking about these traumatic memories is to bridge together the ‘hot’ and ‘cold’ aspects of the trauma. The therapist may start by asking the when, what, where and other contextually relevant things. What were you doing a few hours before the event happened? Who were you with when it happened? The therapist may tell you to stay in the past tense when talking about the trauma so that it doesn’t trigger a flashback or dissociation, but also they will challenge any attempts to avoid talking about it. Reconciling how you felt about what happened, the facts of what happened, and how you feel about it all now is the main goal of Narrative Exposure Therapy.

There are many people in the world today that require therapy but do not have the resources to do so. Specifically, those who are displaced or refugees who come from extremely traumatic backgrounds could really benefit from methods such as Narrative Exposure Therapy. Narrative Exposure Therapy model is not meant to be a long- term therapy, but rather a quick and effective short-term therapy. Hopefully, by the end, you have reconciled more of your past and have a better outlook on your future. Also, your sessions could have a larger impact on the world should you decide to turn your autobiography into a testimony.

Hopefully, by the end, you have reconciled more of your past and have a better outlook on your future. Also, your sessions could have a larger impact on the world should you decide to turn your autobiography into a testimony. Narrative Exposure Therapy at the end of the day can be not only helpful for you, but for others in similar situations.