This Is Your Brain on Trauma

It’s happened more than once: a coach or leader struggles to connect with a team member. They call in a third party, assigning the problem to the athlete. “They’re just not coachable,” the coach says. “They don’t listen.”

Often–alas, very often–it’s apparent that the athlete in question is dealing with a history of trauma. Let’s define trauma, since the word gets thrown around a lot these days. There are many different ways to define trauma. One way is to consider stress as a vast continuum, with eustress or “good stress” at the one end–for example, the stress of improving your skills in an activity you love–and traumatic distress on the other. Traumatic stress is the kind of distress that dismantles your sense of self and your understanding of how to navigate the world.

Trauma is endemic to the human experience. We will all likely face trauma in our lives. Trauma, in the classical sense, is a wound to the soul. To paraphrase the great philosopher-physician Gabor Mate, trauma is not what happened so much as what happens inside you as a result of what happened. That can include the support you did not receive; the resources–including simple recognition of your suffering–that you were denied or that no one knew to offer you; or the beliefs you developed about yourself or the world around you as a result.

“So then, they just need to change their mindset,” certain coaches and leaders may say of athletes or other members of their group. And they’re not wrong that mindset is powerful, and mindset can change. But, in order to support a change in mindset, it can be helpful to first understand the ways that trauma changes the brain. (Trauma changes other physiological systems too, but today we’re going to focus very broadly on the brain.)

Your brain has three evolutionary layers that develop from the “bottom up”:

• Your brainstem or your “reptilian brain,” which is connected to your spinal cord and is responsible for automatic, life-sustaining functions. Let’s call the heel of your hand your brainstem or lower brain, and your forearm bone your spine (model not to scale!)
• Next is your limbic area or mammalian brain, which helps to detect emotional salience of events and interactions and supports memory. Fold your thumb across the middle of your hand, and let this roughly represent your limbic area.
• Now, fold your other four fingers over top of your thumb, and we’ll call this outer overlay of your fingers and the back of your hand your cortex, which is the upper part of your brain that develops last and is particularly prominent in humans. Our cortex and in particular our prefrontal cortex is what allows us to pause, think, reflect, solve problems, and so on.

All three of these brain areas are affected by trauma in a variety of ways, but let’s focus on three broad changes.

First, let’s talk about what can happen in your reptilian brain. We’ll focus today on an area called the Periaqueductal Gray (PAG), which plays crucial roles in processing and controlling pain and in physiological responses to perceived threat. Trauma can heighten the reactivity of the PAG, such that someone experiencing traumatic stress or post-traumatic stress might have what feels like alarm bells going off in their brainstem and their body. Most people with constant alarm bells ringing are driven to do something to quiet them. You can probably picture a range of ways this desperation for “quieting” the alarm might play out: one person might try to destroy whatever seems to be causing the ringing, another might attempt to run away. Others might attempt to self-soothe or seek soothing from another person or substance. And so on.

Next let’s look briefly at your mammalian brain or limbic area. Here we might see increased activity in the amygdalae, your little almond-shaped emotional salience detectors–tossing off warnings to your whole system: threats are everywhere—along with shrinkage of your hippocampus, affecting your working memory. (Can you hear that play out at practice or in the time-out huddle: “Didn’t I just tell you to be patient and not to throw the ball away? Weren’t you listening?”)

Finally, let’s look briefly at the prefrontal cortex. If your threat-response system operates from the bottom up, and your lower brain and mid-brain are very active, you can imagine this leads to decreased activity in the prefrontal cortex, which is what many studies of the effects of trauma on the brain bear out. It’s not a matter of choice–to problem solve or not to problem solve, to decide to control an impulse or not to control it–because when your brain is responding to a threat, your lower brain areas are driving the bus, and your cortex is coming along for the ride.

There’s a lot more we could say about how trauma affects the brain, and we’ll save that for another day. For now, let’s conclude with a few strategies–what we can do to help people quiet their alarm bells safely. And one of the first things we can do is to promote awareness: we can remind ourselves and our athletes and teammates that trauma heightens our neural alarm systems, that it’s not shameful and in fact, it’s adaptive. It’s because your brain is so smart and so sensitive to your environment that you’ve developed this response.

Next, we can work to build safety in the present environment. There are many ways to do this, and not all of them are always possible or accessible, so it’s helpful for leaders and athletes to build a robust toolkit, including “top-down” strategies (using the reasoning power of the prefrontal cortex to communicate with the rest of the body) and “bottom-up” strategies (using the body to communicate cues of safety and agency up to the rest of the brain) and promoting access to clinical and pharmaceutical support where needed. We can also work, as leaders, to dismantle threat-cues that resemble the environment in which someone’s trauma occurred. And where that’s simply not possible, acknowledging a person’s survivorship and their body’s ingenuity in protecting them–communicated with words of affirmation and body language (e.g. nonjudgmental facial expressions and eye contact, an unrestricted or unconstrained vocal inflection, reminders of choice and a person’s capacity to choose how they move their body) can a long way toward healing.