The Neurobiology of Trauma 

By: Delilah De Kay, MSW Intern Therapist

Created: February 27, 2025

Published: March 13, 2025

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Trauma can have a number of different impacts in the brain. In order to understand how trauma affects the brain, and our memory of traumatic events, it is important to understand what different kinds of trauma exist, the mechanisms by which our brain attempts to protect us during traumatic events, and ways that the brain can recover and heal after trauma. 

There are three different kinds of trauma: 

        ● Physical trauma occurs when there is external damage to a person’s body, whether that is a cut, bruise, broken bone, traumatic brain injury, etc.‍

          ● Emotional trauma refers to the emotional impact of a distressing event, and can include emotions such as intense anger, fear, or sadness. 

          ● Psychological trauma refers to the broader emotional and cognitive impacts of a traumatic event. This can include changes in thought patterns and             behaviors, and mental health issues such as Post-Traumatic Stress Disorder (PTSD). 

Additionally, trauma can be categorized as acute or chronic. Acute trauma relates to a single, intense event, whereas chronic trauma is repeated and occurs over a period of time. An example of acute trauma can be an event such as a car accident, whereas chronic trauma can occur in the context of domestic violence or childhood abuse. 

Several regions of the brain play a role in how we react in moments of acute stress. The prefrontal cortex is the region of the brain that is responsible for decision-making, and we rely on our prefrontal cortex to help us think rationally. 

During a stressful event, our brain goes into what can be considered a “survival mode”, where the fight-flight-freeze response kicks in. When our brain enters this “survival mode”, the prefrontal cortex functions less effectively, or “goes offline”, which can also impact our memory of a traumatic event. The amygdala plays a crucial role in activating fear responses such as fight-flight-freeze, and is also responsible for processing emotions, including our reactions to perceived threats (Šimić et. al, 2021). It is important to understand that the fight-flight-freeze responses evolved as a way to protect humans from danger, and it is our brain’s internal wisdom that helps us react quickly to keep us safe in threatening situations. 

The hippocampus is a highly adaptive region of our brain that controls stress responses, memory, and other brain functions (Sperry, 2016). Prolonged exposure to stress damages the hippocampus, impairing memory, emotional regulation, and the brain's ability to process and respond to stress effectively (Sperry, 2016). 

There are many evidence-based treatment options that may be used to help individuals heal from traumatic experiences. Three of the most commonly recommended therapeutic interventions used to address PTSD include Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and trauma-focused Cognitive Behavioral Therapy (CBT), as these treatments have strong evidence supporting their effectiveness and specifically target memories, thoughts, and emotions related to the trauma (Watkins et. al, 2018). These interventions work by helping individuals process and reframe their traumatic experiences, reducing the emotional impact of the experiences and improving overall mental health and well-being (Watkins et. al, 2018). Although trauma can have long-lasting effects, the brain’s incredible ability to heal and adapt creates a pathway to healing with the right support and interventions. 

References: 

Šimić, G., Tkalčić, M., Vukić, V., Mulc, D., Španić, E., Šagud, M., Olucha-Bordonau, F. E., Vukšić, M., & R Hof, P. (2021). Understanding Emotions: Origins and Roles of the Amygdala. Biomolecules, 11(6), 823. https://doi.org/10.3390/biom11060823

Sperry, L. (2016). Trauma, Neurobiology, and Personality Dynamics: A Primer. Journal of Individual Psychology, 72(3), 161–167. 

https://doi-org.ezproxy.uta.edu/10.1353/jip.2016.0014 

Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions. Frontiers in behavioral neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258

Image from: BrainLine. (n.d.). How PTSD affects the brain. BrainLine. Retrieved February 27, 2025, from https://www.brainline.org/article/how-ptsd-affects-brain