Toward an integrated theory of trauma

This dissertation will present an integrated model of trauma. It will concern itselfwith the psychobiological, emotional, perceptual, and phenomenological processes that occur during experiences of trauma and extreme stress, and their significance to a new paradigm of mental disorder. The dissertation will begin with the commonly accepted characterization of trauma as depicted in DSM-IV TR. This will be followed by a brief discussion regarding the history of trauma theory and its relevance to current focus in the fields of psychology, psychiatry, and neuroscience on traumatic symptomatology. Next, the neural foundations of emotional perception will be presented, followed by a discussion regarding conventional research into the symptomatic aspects of post-traumatic stress disorder. This will be followed by a discussion of the psychobiological foundations of traumatization and their relevance to a new understanding of post-traumatic stress disorder, which, of necessity, leads to a psychoneuroimmunological view of trauma. This may be best described in a proposed unified model of etiology of mental disorder, which posits a differential view of traumatic stressors, and a mind-body theory of pathology and approach to healing and treatment, three examples of which will be identified and discussed. In more specific terms the dissertation will provide the conceptual tools to understand what happens neurobiologically when traumatized individuals experience flashbacks and re-experiences of traumatic circumstances, and associative responses of dissociation. Simply, these are the product of the combined effects of heightened fear conditioning, memory disturbances resulting from overcontrol by the amygdala and disengagement of the hippocampus, in conjunction over time with the failure of human efforts to cope. It will be proposed that dissociative responses arise out of hippocampalweakening and secondary effects of the physical and emotional pain that these phenomena engender. This leads to an understanding of why and how such memories appear to become more prevalent, overincorporative, and indelible, especially as the severity of trauma to the system increases. Better understanding of these phenomena may lead to a unified theory of unconscious process and the origins of human dysfunction and pathological mental disease, such as the one herein proposed, which points toward restoration of individuals affected by traumatization