Hi, it's Steve here again. I'm back for audio two in the trauma series. In the first episode I talked more broadly about what trauma is and the complexities of defining trauma. I want to initially just expand on that a little further before then talking about how we might become traumatized or how one gets PTSD or complex PTSD.

So I'd like to break down the difference between type one and type two trauma. So type one trauma is typically defined as a single incident trauma or traumatic event, like a sudden or unexpected trauma, a single episode or experience of trauma. And a type two trauma, more commonly associated with complex trauma, usually involves a fundamental betrayal of trust in primary relationships that we might have.

Often that's interpersonal trauma carried out by a person known to the victim, not always of course but parents and caregivers are often involved in that process often, unwittingly actually. Type two traumas affect in as many as one in seven children or one in 10 children and, often occurs in combination with other traumas happening.

So for example, maybe one witnesses domestic violence and then is emotionally neglected those would be two different categories of type 2 trauma and there is a higher risk of post traumatic stress disorder developing. So how does post traumatic stress disorder develop, or PTSD, I should probably refer to it from this point onwards. We have two parts of the brain where we store memories. We've got the ancient threat system, the alarm system, the amygdala, which I've talked about in previous audio in the CBT series. As you will now know, hopefully, that the amygdala is ancient and not terribly sophisticated. We needed it to manage the level of threat that was proportionate at the time.

But our brains upgraded as we developed and evolved, and hopefully for most of us the level of threat within which we live diminished somewhat. But yeah, it's not terribly sophisticated, it can't tell the difference between real or imagined, and it can't tell the difference in time, i. e. was, is this now or was this in the past? And we have this other part of the brain where we typically store memories, and that's the hippocampus, which is extremely intelligent part of our brain, very sophisticated part of our brain. And that's where we tend to store good and bad memories, which is why when something's nicely filed away in there, even if it's a bad memory, we can think about it and not feel too much distress about that memory.

But, for whatever reason the hippocampus doesn't tend to work that well in the moments where we're under extreme stress or threat or terror. And there are lots and lots of reasons, not all of them fully understood as to why that is it might be that one learns dissociative coping mechanisms from early on, it might be that one learns to avoid emotionally, or there might be a genetic component to it and an environmental component to it, but for whatever reason, the the hippocampus doesn't work that when we're under extreme stress and terror. And so that means that the memory's really got only one place to go, and that is inside the amygdala. Now, we're very good at boxing off memories and trying not to think about them, but naturally, as we try to go about our daily lives the lid can come off that box and we can be reminded of that event.

Let's say my trauma was to be in a car crash and I got over it, I tried not to think about it too much, but every time I hear a screech of brakes or something like that, my amygdala is reminded of that event. My brain is reminded of that event and it shows me the event. It shows me images, perhaps; oh, there's that thing you haven't dealt with.

So really it's trying to helpfully say, don't forget this, but it doesn't feel like that because of where the memory is. So the memory then..it might mean that we see images of it, but because of where it is, it sounds the alarm to our threat system and our nervous system and our body that we're in danger.

So now I'm seeing images of it and feeling like I felt back then at the same time. So we get that kind of sense of reliving that sense of nowness connected to it. And that's effectively how flashbacks work. I hope that's clear, I hope that's explained something to you and as I mentioned before, it's not just what happens to us, it's the meaning of what happens to us, the appraisal of that event.

And so for example, in my car crash, for example, my imaginary car crash, I hope that doesn't trigger anyone too much. The meaning might have meant, I'm going to die. So that's why, traumatized people, it's hard to rationalize with that trauma because the appraisal is stuck and I, there's a part of me that is essentially stuck in that memory thinking that he's going to die.

So that's key when we talk about trauma processing and I'll address that in other audios. But effectively that's how PTSD can form, really. We have the traumatic event, we might have memories of it, that might, we might get that through a reminder, or through a nightmare.

And that traumatic effect of that event might lead us to those memories or i t might influence our belief system, it can, trauma can turn our belief system upside down. And that can bring us to this sort of current sense of threat. It might be shame, disgust, or, usually fear. And then that leads us to like avoidant coping strategies, like maybe drugs or alcohol or just not going out as much, which means that the memory doesn't get challenged and the beliefs don't get challenged.

And then we pack it away again and then until we're triggered again, and then we keep going into that cycle of, being triggered. The brain says there's that thing you haven't dealt with. We feel like we're reliving it. So we try to shut it down and it doesn't get challenged, and so on.

And typically what whether it's type 1 or type 2, i. e. PTSD or complex PTSD, you tend to see people who are very stuck, who have had to make their worlds quite small in order to cope with the triggers.

I hope that's helpful.