Trauma, by Professor Gordon Turnbull

Trauma, by Professor Gordon Turnbull

From Lockerbie to 7/7: How Trauma Affects Our Minds, and how We Fight Back

Psychological trauma is a phenomena as old as humanity. Ancient Egypt soldier ‘Hori’ recounts the terror preceding battle: ‘You determine to go forward [...] Shuddering seizes you, the hair on your head stands on end, your soul lies in your hand.’ Herotudus the first Historian, tells of the Athenian warrior, who became stricken by blindness after battle, though ‘being wounded on no part of his body.’  Samuel Pepys, London diarist, and man about town, says the Great Fire has caused ‘sleeping and waking, such fear of fire in my heart, that I took little rest.’ The best account of trauma so far: Shakespeare’s play Henry IV, Lady Percy, soliloquizes on her estranged husband: ‘O, my good lord, why are you thus alone? [...] In thy faint slumbers I by thee have watch'd [...] [heard] Of sallies and retires, of trenches, tents [...] And thus hath so bestirred thee in thy sleep, That beads of sweat have stood upon thy brow [...]  And in thy face strange motions have appear'd.’ 

Flash-forward and trauma has been with us ever since: From World War I to Iraq and Afghanistan, shell-shock to post-Vietnam-syndrome. However it was only in 1980 that the DSM V created the diagnosis PTSD. While tending to the survivors of Pan am flight 103 and Lockerbie, pioneering trauma psychiatrist Gordon Turnbull had an epiphany: Until then, PTSD had been viewed as a mental illness and suggestive of an innate character flaw. Turnbull saw what he saw, and subsequently broke ranks: ‘PTSD was not an illness, but a survival tool [...] [it] wasn’t a case of the body going wrong. It was a natural response to highly unnatural events.’ Common sense now, but in the old days it was a radical step from tradition and had a profound effect on treatment. 

The first part of the book is perhaps little too rambling and self-indulgent and at some points almost reads as an autobiography: One ‘polymath’s’ rise in the psychiatric profession and the innovative theories he discovered. Perhaps this can be forgiven because Turnbull is not only recounting his own life, but discussing the long drawn out development of trauma theory. And it is true he played a part in getting the diagnosis the recognition it deserved. The latter half of the book really illustrates how primitive treatment was, even three decades ago. It shows how far we have come from psychoanalysis to Neurology! 

The book really shines when it is discussing cutting edge research into trauma. Turnbull is a talented writer, who makes extremely complex events occurring on the molecular level understandable. According to him psychological trauma actually has a ‘Biological signature’: The hippocampus acts, ‘a bit like a USB cable connecting left and right side of the brain.’ Left brain is used to store memory, right brain sensory impressions. High levels of stress hormones like cortisol and adrenaline ‘nibble away’ at the hippocampus ‘and kill the nerve cells,’ creating a failure in function. Flashbacks, the core PTSD symptom occurs because the hippocampus now ‘has difficulty passing sensory information from the right to left side of the brain.’ 

But there is more: Disassociation is not just zoning out but can be accounted for by ‘hypo-arousal,’ ‘tonicity,’ or in layman’s term ‘playing dead;’ an evolutionary tool from our jungle days. Physical problems from IBS to headaches, can occur, because the brain releases neuropeptides when in a state of arousal. These peptides ‘reach into all organs and tissues of the body [...] [meaning] that emotional memory is stored in the body’ as ‘imprints’ which provoke, physiological changes. Finally even the most maladapative behaviors, like drinking, drugs and even violence, seen ‘through the eyes of a trauma victim’ are tools for adaption: Avoidance is where ‘the left side of the brain shuts down,’ Alcohol and drugs, ‘boost [damaged] endorphin levels,’ and finally violence, is a ‘conditioned response,’ and outlet for chronically high levels of adrenaline.  

Overall, the theory is this: The brain is using its greatest tools on a psychological, physiological and neurological level, to help us survive. However, our greatest asset, is out of sync with modernity, for we are no longer on the African Savannah. Nevertheless, the brain still behaves as if we do, and will do anything to help us live and reproduce!

Admittedly Turnbull is a little too radical in some respects advocating hypnotherapy, Eye movement desensitization and reprocessing, tapping and emotional freedom technique, and even speaks of a sixth sense. While some of these ideas like ‘EMDR’ and ‘intuition’ are becoming empirically validated, others like hypnotherapy need more research. Concepts like ‘Emotional Freedom Technique’ and ‘thought field therapy’ on the other hand are unscientific in my opinion!Nevertheless, Turnbull is an engaging and convincing author. In the future who knows maybe some of his more radical ideas will find mainstream acceptance. Ultimately, his book not only discusses the symptoms of trauma but also the way to recovery: ‘Neurogenesis,’ and ‘neuroplasticity.’ The brains ability to rewire and remake all the damage trauma causes, and turn it into a new beginning.