Zsófia Molnár sat sunken in her seat, heart pounding, palms soaked in sweat, unable to recall who the U.S. president was in 1986. On a normal day, Molnár could tell you every tedious detail leading up to major political events, but on the afternoon of her debut college exam, her mind went blank as years of trauma resurfaced. Suddenly feeling nauseous, she dashed through the swinging doors of her lecture hall, ran to the bathroom, and never returned to her exam.
Although she’s never made more than minimum wage working as a grocery store clerk, the mild-mannered brunette is an ardent history buff: through Zoom, I see stacks of titles by Edward S. Herman and Jared Diamond strewn across her poorly lit basement suite. Earlier, she began explaining how Gnaeus Pompeius Magnus led to the fall of Julius Caesar, discussing the Roman general as though she were explaining a close friend’s eccentricities.
Molnár speaks knowledgeably on many topics, but when she was a freshman at college her grades plunged so low she decided her only option was to drop out. She’s never returned. For years, she has believed her potential reaches beyond the till — “I know I can be more than this” — but she is both frustrated that her educational status stands in the way and terrified of going back.
Edmonton-born Molnár — whose name has been changed due to the sensitive nature of her story — isn’t alone in not obtaining the degree she once pursued. According to a 2011 Youth in Transition Survey by Stats Canada (the most recent federal data on file), roughly 250,000 Canadians (or about 21 per cent) dropped out of their post-secondary studies between 2000 and the end of 2005.
In surviving childhood abuse, Molnár also belongs to the 26 per cent of Canadian adults who share that harrowing experience, according to Stats Canada’s 2014 General Social Survey data. There is a strong correlation between the two: trauma limits students because those early experiences heighten their stress response well into adulthood. Common situations in post-secondary environments, such as exams — which are typically pressing but shouldn’t be terrorizing — can wipe out both recall and long-term thinking in abuse survivors.
Molnár grew up in a household where her mother routinely quizzed her and her brothers on trivial subjects; if they gambled with the wrong answer, a coffee cup might fly past their heads or a wanton hand might cross their cheeks. Despite resting dormant most days, the terrorizing panic from those early years comes to life any time the 27-year-old is questioned in a high-stress environment. It’s not that visual memories of her abuse emerged during her exam that day, Molnár recalls, but her nervous system freaked out. “Your mind forgets the trauma, but your body doesn’t,” she recounts a clinician telling her years later. “You can’t talk yourself out of it.”
A groundbreaking new study recently published in the Journal of Psychiatry & Neuroscience outlines how trauma atrophies certain areas of the brain in childhood abuse survivors — namely, the amygdala and hippocampal subregions. One area of the amygdala, known as the basolateral complex, is involved in learning and memory. “Childhood adversity, including trauma and maltreatment,” the authors write, “can induce biological changes in stress-related brain structures, which may then become maladaptive in adult environments.”
One of the study authors is Dr. Peter H. Silverstone, a physician and psychiatry professor at the University of Alberta, who has worked in the field of childhood trauma for over 40 years. He says experiences of abuse also set people up to be more vulnerable to health issues such as major depressive disorder, generalized anxiety disorder, and panic disorder.
“People talk about potential changes in the amygdala, but no one has ever looked at these subregions and found them,” he tells me. “So these changes in volume are there, and they seem to reflect stress and trauma from a young age.”
Until recently, studies of the amygdala using MRI technology have only been able to examine its total volume. Now, with advancements in medical imaging, researchers can measure individual amygdala subnuclei. This scientific breakthrough led to Silverstone and his team’s findings.
“So that’s what we found and I was really excited,” the British-born neuroscientist says. “I've been working on childhood trauma [and] how it impacts people in the long term for years,” he emphasizes. “We haven’t previously known exactly what it was that the trauma led to in the brain. But now we have that.”
The amygdala’s basolateral complex, the professor explains to me, didn’t develop as well in the 35 people studied who had been subject to trauma when they were young as compared to a control group.
“Imagine your brain is working at 90 per cent capacity,” Silverstone says while elaborating on how this affects his patients and people like Molnár. “At a time of high emotional stress, “the regions that would normally respond, can’t respond.” The panic can’t be calmed by reason or thought.
Silverstone feels that his and his colleagues’ research has brought forth “much more evidence about the fact that [these brain changes] are real” and result from various adverse events, “which can be emotional abuse, long-term bullying, emotional neglect, and physical abuse,” he says. “Whatever the traumas are, according to our article, it leads to long-term damage to those regions of the brain where they don’t grow as much.”
New treatments emerging
Abuse also leaves its mark on the hippocampus, which is responsible for memory and recall. “If you have a severe trauma — sadly, the commonest that I see is the sexual abuse of women — it seems to involve an overload of neurological activity that, not surprisingly, [creates] almost an imprint within the hippocampus, which leads to PTSD.”
Now that his team has been able to both find and publish such strong evidence, Silverstone’s next question is, “So what can we do about it?”
The treatments he is most excited about include therapies such as mindfulness, the therapeutic use of psychedelics such as psilocybin, and eye movement desensitization and reprocessing (EMDR). “In terms of therapeutic benefits, EMDR turns out to be very effective,” he says. “It seems to show some remodeling brain plasticity evidence.”
EMDR works by using a patient’s own rhythmic eye movements to process emotions surrounding traumatic events. One technique applies a pulsar that buzzes between the patient’s right and left palms, but many other standardized protocols incorporating eye movements (such as taps or tones) exist to “allow for the spontaneous emergence of emotions, sensations, or memories.” These eye movements dampen the physiological effects of emotionally charged memories of past traumatic events.
Silverstone admits that when the therapy first came out, he didn’t give it much credence. But today, the field of neuroscience is better positioned to understand what EMDR does. “Probably the best explanation I’ve seen, and this will come as a surprise — sorry, that’s sarcasm, I’m English — is the fact that it goes through the amygdala and the hippocampus.
“I suspect that what we’ll see over the next few years is therapies such as EMDR and psychedelics including psilocybin and ketamine that will allow brain plasticity to occur,” the professor notes.
“I'm more optimistic now about new treatments than I’ve been in a very long time.”
Silverstone’s research — both on the effects of childhood trauma and on treatments — may bring hope for those who’ve been set back by the physiological effects of trauma, which prevent people like Molnár from functioning at their full capacity in academia.
The question that remains for Molnár is whether such treatments might one day be included in Canada’s provincial healthcare systems. “If I had known this when I was younger — if my doctor had known about these treatments — I might have been able to finish my courses,” she says after I ask what she thinks of Silverstone’s research.
“If you fall and hurt your back, the hospital is there to help so there’s no long-term damage. But if there’s an injury to your brain or your nervous system that causes this damage, you’re on your own? That needs to change.”