How does PTSD get started? Horror, Helplessness combine with Episodic memory.

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This is my second guest-post on cipher method dreaming and its relationship with PTSD/EMDR for Erin’s blog. Of the posts of mine that Erin read, she appeared to linger on post 30, which I will quote after this re-organization of my posts for those who follow Erin’s log.

It is color coded to help draw the eye to posts connected by a theme.

In the 1st post I mention, posts 2 – 10 and 14 that explain the cipher method by example dreams in 7 languages, and by the model presented in post 4, and by the brief history of the ancient roots of cipher method presented in 11, 12 and 13.

Tori’s nightmare is a recurring theme in Part 2. The main mention of it occurs in posts 28, 29 35 and 36

If you intend to connect Tori’s nightmare to my thoughts on PTSD and then EMDR, you might want also to review posts 30, 34, 39 and 42.

Episodic memory is key to understanding PTSD nightmares, and the essential posts there are 31, 32, 33, 

Now for my 30th post, which is part of the Tori’s nightmare series: first the link and then the post.

How does PTSD get started? Horror & Helplessness combine with Episodic memory. (30th post, 15 Sept. 2017)

How does PTSD get started? Horror & Helplessness combine with Episodic memory. (30th post, 15 Sept. 2017)

Part 2: PTSD Nightmares and ISMcm [Inner Speech Metaphorization cipher method]. Begins in post 28.

The discovery of the episodic memory system was essential to understand the eidetic memory that produces PTSD nightmares. The horror of such nightmares is a compound of two features that are possible in dreams: 1st, they are hallucinoid (they feel like they are occurring in the real world); 2nd, they are eidetic (a faithful replaying of an actual waking experience).

It is not yet proven why nearly all dreams are hallucinoid. That they are, is a given.[1] In ISMcm theory (see post 4, the Cognitive Model of the ISM cipher method) it occurs because the Vigilia circuit (a.k.a. the waking consciousness cognition, or WCC) experiences the dream as it is played by the Somno circuit (a.k.a. the Dreaming Consciousness Cognition, or DCC) – in box 4 — and it, the Vigilia circuit, is constructed to treat its inputs as occurring in the real world. This may be why nearly all dream reports from REM awakenings are judged to e hallucinoid.

Episodic memory is responsible for the replaying. Episodic memory was first proposed and named in 1972 by Endel Tulving.[2]

Endel Tulving

 

Endel Tulving, the memory man

In my law practice I saw PTSD often in trauma cases. Traumatic events impact on the episodic memory system first. The sounds and sights and feelings of the event register in real time, along with the horrifying emotions –often a fear of immanent death and helplessness to prevent it. And then, for reasons uncertain, some [3] folks can’t shake that episodic memory and it becomes PTSD and replays eidetically in their dreams. Typically, it then also becomes day-time flashbacks, and the other symptoms of PTSD appear in varying degrees and their lives become restricted by fear of triggering and a generalized anhedonia.

In auto accident cases I long ago noticed that a client had to see the accident developing. If they were asleep in a passenger seat or got hit without warning from the rear, they did not develop PTSD. It appeared that the person had to see it happening or become aware that it was about to happen to experience the necessary precursor, an intense fear or sense of helplessness in the face of impending death or grievous bodily harm.

The explosive emotional release, (a “mass discharge” of the sympathetic nervous system) seems to be one route to condition the person for PTSD’s eidetic replay. Note that this must occur while one is awake, so the Vigilia (waking consciousness cognition) is the one conditioned, and perhaps not the Somno circuit (dreaming consciousness cognition). See post 4, for the role of the Somno and Vigilia circuits.) This may be a clue to what’s happening in the PTSD nightmare: it may be primarily a product of the Vigilia that highjacks the dreaming machinery.

[Brain function in PTSD has been the subject of numerous sleep studies, some of which mention dreams and most mention nightmares but in relation to brain structures.  The 2008 review article of Anne Germaine et al, is often cited. [4] They do refer to Antii Revonsuo’s theory of dreaming as threat simulation and motor rehearsal, [5] which accords with REM activation of certain limbic areas that sleep scientists have identified. They do not mention dream reports.  Where a modern sleep science study considers dream and nightmare reports, typically it is the false narratives arc and not the cipher method sense of a terse linguistic comment on the dreamer’s true context at the time of the dream. I hope to see this change.]

Slower onset of PTSD also occurs.  Repetitive acts of harm as in abuse of a physical or sexual nature to a child who cannot resist appears to create PTSD. It probably does not create the explosive and overwhelming terror of an incoming shell in battle or an oncoming auto in a collision – but it probably does create intense feeling of helplessness and horror mixed with shame and misplaced guilt, in an abused child, each time it happens, and the condition is built up by accretion. Again, this experience is conditioning the Vigilia circuit.

The repetitious build-up of coercion that must be obeyed to avoid painful consequences and the helplessness appears to represent another route to PTSD, one which may be more resistant to effective treatments. My information here is anecdotal and secondhand from treaters of abuse survivors, an area of trauma law in which I did not practice.

Children also experience PTSD differently. The US National Center for PTSD reports the classic trilogy of symptoms in adults compared to children: [6] 

“ (1) re-experiencing, (2) avoidance and numbing, and (3) arousal symptoms … may not present itself in children the same way it does in adults.”

“Clinical reports suggest that elementary school-aged children may not experience visual flashbacks or amnesia for aspects of the trauma. However, they do experience “time skew” and “omen formation,” which are not typically seen in adults.”

Note the absence of mention of nightmare symptoms in children. In a later post I discuss the paucity of nightmare findings in preschool children who are otherwise believed to be experiencing PTSD, and I will suggest that this difference in presentation between preschool age children and older children and adults may be accounted for by the incomplete onset of the episodic memory function in children under 5 years of age.

For at least some adults and children who develop PTSD nightmares from either a single trauma or repetitive assaults, the nightmares do begin to evolve away from a strictly eidetic replay of the traumatic event(s).

Here, finally, we arrive at the point of this “Part 2: Nightmares and ISMcm”: these eidetic post-trauma nightmares do sometimes resolve. As they do, the feature of note is that they cease to be wholly eidetic and begin to have inclusions of the letter-analogues of the cipher method. We will see this in Tori’s nightmares in a later post.

What I understand from one source is that the dreams of a woman who was repeatedly victimized sexually by her father are more richly detailed than the resolving nightmares of my typical trauma victims, and are chock-full of metaphors, implying multiple ISM statements possibly referencing multiple events of abuse in any given dream, when treatment is becoming effective.  In my law practice’s typical trauma case, the ISM’s, the Metaphorizations, reference the single traumatic event, [as well as the newly integrated and metaphorically related events that lead to the inclusions of the letter-analogues].

In the next few blogs, we find important clues to the age of onset of cipher method dreaming from parallels between the onset of episodic memory and the earliest appearance of bizarreness in children’s dreams. We also learn that PTSD may not be diagnosable in preschool children.

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cipher.ken.arenson@gmail.com

© Kenneth M. Arenson, Toronto, ON. Canada

[1] This hallucinoid character of most dreams is shown by a number of studies of REM awakenings, which became possible since REM’s discovery in 1953. See the first such study: Foulkes, D., Spear, P. S., & Symonds, J. D. (1966). Individual differences in mental activity at sleep onset. Journal of Abnormal Psychology, 71(4), 280.

[2] Tulving, E. (1972). Episodic and semantic memory ch.10. Organization of Memory. London: Academic, 381, e402.

Tulving, E. (1984). Precis of elements of episodic memory. Behavioral and Brain Sciences, 7(02), 223-238.

Tulving, E. (1993). What is episodic memory?. Current Directions in Psychological Science, 2(3), 67-70.

Tulving, E., Kapur, S., Craik, F. I., Moscovitch, M., & Houle, S. (1994). Hemispheric encoding/retrieval asymmetry in episodic memory: PET findings. Proceedings of the National Academy of Sciences, 91(6), 2016-2020.

Tulving, E. (2002). Episodic memory: From mind to brain. Annual review of psychology, 53(1), 1-25.

Habib, R., Nyberg, L., & Tulving, E. (2003). Hemispheric asymmetries of memory: the HERA model revisited. Trends in cognitive sciences, 7(6), 241-245

[3] “Some” develop PTSD. It might be that anyone who suffers that explosive burst of emotion of an impending injury, plus the time to feel helpless to prevent it, will experience at least some eidetic replay in nightmares (also day-time flashbacks). But, some people will be more able than others to resolve such PTSD-type nightmares before the condition becomes ingrained or chronic.

[4] Germain, A., Buysse, D. J., & Nofzinger, E. (2008). Sleep-specific mechanisms underlying posttraumatic stress disorder: integrative review and neurobiological hypotheses. Sleep medicine reviews12(3), 185-195.

[5] Revonsuo A., (2000). The reinterpretation of dreams: an evolutionary hypothesis of the function of dreaming. Behav Brain Sci, 23(6):877–901.

[6] https://www.ptsd.va.gov/professional/treatment/children/ptsd_in_children_and_adolescents_overview_for_professionals.asp

PREVIOUS ARTICLE “War Neurosis” (1919): the Freudian take on PTSD after World War I requires the abandonment of the origin of dreams as wish fulfillment (29th post, 13 Sept 2017)

NEXT ARTICLE Tulving (2002) Episodic memory: “the only memory system that allows people to consciously re-experience past experience”. Probably is more an embellishment than an evolved capacity; and first appears at ~ age 4. Is it similar for Post-traumatic nightmares? (31st post, 18 Sept. 2017)

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cipher.ken.arenson@gmail.com

© Kenneth M. Arenson, Toronto, ON. Canada

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