Some have called PTSD a disorder of memory. But can experiencing symptoms after a traumatic event just be due to memory the event. Are trauma and memory so simply linked?
Well, we may not be able to boil it down to juuust that. But in many ways, that statement may be accurate. Memories of the traumatic event (especially intrusive ones) often kick in when there is a reminder of the trauma (“a trigger”). These memories often activate the fight or flight response in the body (sympathetic activation) and in behavior (e.g., avoidance, hypervigilance).
Research has found that the amydala “tags” traumatic events as extremely salient in memory. Those memories (or threat associated with them) are then very powerful for the individual. This tends to occur even when an individual does not have clear memories of the event(s).
There is also an important interaction between our amygdala and prefrontal cortex (we’ll keep this simple). In a basic sense, the amygdala is associated with pure emotional responses (e.g., fear). The prefrontal cortex is the “reasoning” center that allows us to think through situations and inhibit emotional responses (e.g., not yelling at someone in public when we feel angry). These two systems interact in a delicate balance.
PTSD throws off this balance. Research shows a dramatic increase in amygdala reactivity (more raw emotional responses) in PTSD. Prefontal cortex activity decreases at the same time (decreasing ability to cope with raw emotional responses).
So people find it much more difficult to regulate their emotional responses when having a trauma memory. In this case, the traumatic memory arises, fear (and sometimes shame) spikes and the body activates, and there’s a strong pull to escape as a way to cope. Escape/avoidance has even been shown to be a key maintaining factor for PTSD.
So memory is crucial piece of the trauma trigger process. But memory is also a key maintaining factor because memories about the event bias beliefs about it, and vice versa. Treatment often finds that as memories of the event and one’s role in it become more accurate, beliefs about the world, oneself, and safety become less negative and more balanced throughout treatment. This leads to clients to respond more adaptively to triggers in the present.
Treatments like cognitive processing therapy (CPT) and prolonged exposure therapy (PE) are highly effective for these reasons. So whether it’s all about memory or not, at least we have a pathway for clients to provide relief from difficult trauma memories.
