Interpersonal Trauma

Our brains rely on other brains to remain healthy, especially when we are under stress. When faced with illness, catastrophe, or loss, we turn to each other for comfort, security, and stability. Resiliency, or our ability to cope with life's ups and downs, is closely tied to the extent and quality of our support systems. We appear to be capable of coping with just about anything when we are able to stay connected to those who we care for and who care for us. But what happens when we experience trauma at the hands of those we love and depend on? 

Interpersonal trauma is an especially difficult challenge, particularly for children, because it creates competing and contradictory biological and behavioral responses. We want to cling to another for support while pushing them away for protection. It is precisely this approach-avoidance conflict that can make interpersonal trauma so damaging. We see this internal drama played out in front of our eyes in disorganized attachment.  

Learning to hold ourselves away from others may be adaptive in the traumatic situation but subsequently cuts us off from the healthful effects of relationships that we need to heal from the trauma. Thus, interpersonal trauma is more likely to be self-perpetuating and resistant to healing because it underlies the trust we need to connect and put the trauma behind us. When interpersonal trauma occurs early in life, this approach-avoidance conflict can become a consistent state of being around which our personalities are formed. 

We can actually see this inner conflict displayed in the behavior of children with frightened and frightening parents. When these children are stressed, they will run toward their parent while simultaneously averting their gaze, spin in circles, fall to the floor, or engage in other types of apparently irrational behavior. For a child, the simultaneous impulses to run toward and away from a parent make forming secure attachment impossible. Adults who find themselves in relationships that include physical and emotional abuse often turn to drugs and alcohol, become physically ill, or develop severe psychological problems while they struggle to stay close to those who dysregulate them.

Early interpersonal trauma in the form of emotional and physical abuse, sexual abuse, and neglect shape the structure and functioning of the brain in ways that negatively affect all stages of social, emotional, and intellectual development. Early trauma, especially at the hand of caretakers, begins a cascade of effects that result in a complex post traumatic reaction far more damaging than what we see in traumatized adults. The effects often manifest in what are called personality disorders and complex PTSD, which impact many aspects of a person's functioning and are quite resistant to change.

The tenacity of personality disorders rests in an approach-avoidance conflict. If you need to feel safety, trust, and connectedness in order to heal but are too afraid to trust because your brain and body have been conditioned to become fearful and dysregulated in relationships, you are stuck. This "Catch-22" traps victims in a cycle of loneliness-approach-terror-avoidance-loneliness-approach-terror-avoidance, and so on, that is difficult to escape from. Many people come to therapy for years but are too afraid to trust their therapists enough to share themselves openly. They desperately need to establish a relationship in order to heal, but their fears overwhelm them and they flee back into a safe and painful isolation. 

This basic biological principle of regulating through approach-avoidance behavior is seen in reptiles that regulate their body temperature by changing locations. Lacking inner mechanisms of thermo-regulation, they are forced to use changes of location to regulate temperature and survive. When we humans lack the ability to regulate our internal emotional state, we attempt to regulate by “acting out” or running away. When we can't move away physically, we learn to dissociate from reality. For example, abused children learn not to look at faces and are less skillful in decoding facial expressions (Camras et al., 1983). When they do look at faces, they are hypervigilant to any sign of negativity or criticism. When reality becomes too overwhelming they may retreat into fantasy. 

In the face of early interpersonal trauma, all of the systems of the social brain become shaped for offensive and defensive purposes. Instead of the social synapse being dedicated to the free and flexible exchange of information between individuals, it becomes a "no-man's land" fraught with difficulties and dangers. We stare at others trying to predict when they will become dangerous and require us to fight or flee. Mirror systems are employed to defend ourselves instead of attune to others; attachment schemas are converted from strategies for intimacy into battle plans. Faces are explored for signs of disapproval and danger instead of acceptance. Regulatory systems become biased toward arousal and fear, priming our bodies to sacrifice well-being in order to stay on full alert. Reward systems designed to make us feel good through contact with loved ones are manipulated with drugs, alcohol, compulsive behaviors, and self-harm. When the brain is shaped in this way, social life is converted from a source of nurturance into a mine field.

This is an excerpt from Dr. Cozolino’s book The Neuroscience of Human Relationships.