Monday, April 30, 2012

A Neurologist’s Explanation for Trauma, Dissociation and Chronic Pain

Taken from

During his keynote address to the Association for Applied Psychophysiology and Biofeedback, Dr. Robert C. Scaer invited fellow clinicians to “look beyond the dysfunctional behavior apparent in many PTSD patients to the neurophysiological and autonomic dysregulation that is the source of their symptoms and eventually their disease.”

“Medical science must shed the concept that a symptom, not measurable by current technology, is ‘psychological’ and therefore invalid,” he stated, and encouraged physicians to reject the pejorative implications of the term “somatization” and to stop further traumatization of patients by subtly implied rejection.

Referencing extensive research carried out over several decades, including that of Dr. Peter Levine in the field of somatic experiencing (SE), Dr. Scaer proposes a model of PTSD linked to “cyclical autonomic dysfunction.”

Case In Point: Whiplash Syndrome

According to Dr. Scaer, Whiplash Syndrome constitutes a model for traumatization rather than physical injury; many of its symptoms and clinical manifestations are in fact a universal, animal response to a life threat in the face of helplessness.

This hypothesis is based on the occurrence of dissociation at the time of the motor vehicle accident in the form of numbing and an altered state of awareness, often attributed to concussion.  Scaer reminded the audience that individuals who actively dissociate at the time of a traumatic event are much more likely to develop subsequent symptoms of PTSD than those who do not. Furthermore, he added, children are especially prone to dissociate at the time of a traumatic experience.

Whiplash Syndrome has proven very difficult to treat. Individuals who develop it after a whiplash trauma suffer continual headaches and pain, reduced movement at the back of the neck, tingling in the arms, lumbar pains, fatigue, sleep disruptions and reduced libido. Moreover, in a small percentage of people, these symptoms can persist for months or even years before settling. Yet, even then, residual long-term neck discomfort may be experienced.

These subsequent clinical symptoms are explained by theories of limbic “kindling,” Scaer said. Kindling, he explained, is the name given to the phenomenon of the progressive development of self-perpetuating neural circuits. The symptom can be produced in rats by repetitive time- and frequency-contingent regional electrical brain stimulation. The behavioral expression of kindling in humans may include epileptic seizures and is also a model for a number of clinical syndromes, including PTSD. Read on

Dissociation: the escape when there is no escape ~ Frank Putnam

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