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What is the HPA Axis

The hypothalmic pituitary adrenal axis.


What sets the HPA Axis in motion?

The limbic system, responding to extreme trauma/stress/threat, sets the HPA axis in motion, telling the body to prepare for defensive action.


What chemicals are released when the HPA Axis is set in motion, and what is the effect on the body?

Repenephrine and norepenephrine, quickening heartrate and respiration, skin pales as blood flows from the surface to the muscles, and body prepares for quick movement.


How does the limbic system respond when flight and flight are both perceived to be impossible?

The limbic system commands simultaneous heightened arousal of the parasympathetic branch PNS of the autonomic nervous system ANS, and tonic immobility.


What bodily mechanism halts the alarm response, but is insufficient in people with PTSD?

Cortisol secretion.


People with PTSD live in a chronic state of ____ activation.

Autonomic nervous system (ANS) activation, or hyperarousal.


In PTSD sufferers, what is the cause of the distressing, and disabling symptoms of heightened pulse, paled skin, cold sweat, etc.

Repeated recall of autonomic nervous system (ANS) activation, the body's high alert that occurred during the original trauma.


Under normal circumstances, what is the relationship between the SNS and the PNS?

Balance. Both are always activated, but when one is up, the other is down. SNS is usually aroused by positive / negative stress (exercise, danger) and PNS aroused by rest, sexual pleasure, etc.


What would indicate the successful processing of trauma?

Can recall and describe the event; can make meaning of it; have appropriate emotional reactions; and can perceive it as clearly in the past


Generally speaking, people with PTS/PTSD remember trauma in two different ways. Describe them and note what they both have in common:

1. Clear, film-like memory of the trauma, with either powerful and innappropriate emotions or numbness and deadening.
2. Vague, or lack of memory of trauma accompanied by physiological sensations that don't make sense.

(In common): both experience danger as present, not in the past.


What is the difference in malleability between different brain systems?

More complex systems are more malleable. The cerebral cortex is very malleable and influenceable, while the brain stem is less so.


Define resilience

Being able to swing with the punches dished out by life


Why is healthy attachment good for the brain?

In babies, healthy attachment relationships with caregivers stimulates key brain development, helping to develop resilience


What are synapses?

The electrical or chemical (neurotransmitter) link between neurons (nerve cells)


What are some examples of basic synapse strings and complex synapse networks?

Basic string: a feeling, a blink, a basic action
Complex: walking, speaking with someone


What are two chemical synapses and what systems do they come from?

Epinephrine: Adrenal
Nor-epinephrine: the other sympathetic nerves


What does a buildup of norepinephrine lead to?

Fight or flight


What type of nerves are Brain -> Body, sending messages about behaviours?

Efferent nerves


What type of nerves are Body -> Brain, sending messages about body position?

Afferent nerves


What is the lower brain, and what functions is it implicated in?

The brain stem: breathing, heartbeat, etc.


What are some of the main parts of the mid-brain and what fuctions?

Limbic system, hypocampus, amydala, ANS. Instincts, reflexes related to safety, danger, sex, food, etc.


What is the upper, most advanced part of the brain?

Cerebral cortex


Describe some differences between the functions and development of the amygdala and the hippocampus

Amygdala: responsible for processing emotional reactions and sending that to the cortex. Functional at birth
Hippocampus: Makes sense, provides context, sequencing on a timeline. Develops from 1-3 years


What is unique about the hypocampus regions of PTSD survivors?

It is smaller, although not clear if it got smaller from PTSD, or if PTSD resulted because HC was already smaller


Why does extreme stress have the potential to distort memory and make processing experience difficult?

Stress hormones, like cortisol, may suppress the function of the hippocampus


Explain how bi-lateral brain function may contribute to the "speechless terror" of trauma?

The amygdala is associated with the right hemisphere, while the hippocampus is linked with the left hemisphere. The left hemisphere also contains Broca's Area, believed to be responsible for speech. Both Broca's Area and the hippocampus are suppressed in trauma.


Explain how a mother helps a child build resilience (in the context of amygdala and hippocampal function)

The early attachment bond with baby are right brain focused, where the mother helps baby regulate in response to stimuli, by soothing, regulating, and calming the baby who is being newly and overly stimulated. Later, the mother helps a toddler by setting rational limits, socializing, using language to make sense of experience.


What early life conditions are PTSD risk factors, and why might this be (in relation to brain function)?

Early trauma and lack of a healthy attachment bond. Both mean that child will be less able to self-regulate, because there is reduced hippocampal activity, either from lack of attachment bond stimulation, or because it was suppressed by trauma.


What is the key brain structure to making sense of and moving on from trauma?



Can anything be done about lack of a healthy attachment bond?

Yes. Healthy attachment can come later, in the form of a friend, counsellor, etc.