The Body Keeps the Score: the Insula

 

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Almost every brain-imaging study of trauma patients finds abnormal activation of the insula.
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This part of the brain integrates and interprets the input from the internal organs—including our muscles, joints, and balance (proprioceptive) system—to generate the sense of being embodied.
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The insula can transmit signals to the amygdala that trigger fight/ flight responses.
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This does not require any cognitive input or any conscious recognition that something has gone awry—you just feel on edge and unable to focus or, at worst, have a sense of imminent doom.
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These powerful feelings are generated deep inside the brain and cannot be eliminated by reason or understanding.
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Being constantly assaulted by, but consciously cut off from, the origin of bodily sensations produces alexithymia: not being able to sense and communicate what is going on with you.
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Only by getting in touch with your body, by connecting viscerally with your self, can you regain a sense of who you are, your priorities and values.
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Alexithymia, dissociation, and shutdown all involve the brain structures that enable us to focus, know what we feel, and take action to protect ourselves.
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When these essential structures are subjected to inescapable shock, the result may be confusion and agitation, or it may be emotional detachment, often accompanied by out-of-body experiences—the feeling you’re watching yourself from far away.
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In other words trauma makes people feel like either some body else, or like no body.
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In order to overcome trauma, you need help to get back in touch with your body, with your Self.
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There is no question that language is essential:
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Our sense of Self depends on being able to organize our memories into a coherent whole.
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This requires well-functioning connections between the conscious brain and the self system of the body—connections that often are damaged by trauma.
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The full story can be told only after those structures are repaired and after the groundwork has been laid:
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after no body becomes some body.
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