It’s a Small, Small World: PTSD as Self-Imprisonment.

What's the best way to help someone with PTSD? Understand it.

Rachel Yehuda: War changes people and this is something that we’ve known since recorded history. It’s spoken about in literature throughout the ages. It’s kind of a brotherhood of combat veterans and for many, many years it stayed in the brotherhood. And a lot of people came back from World War II, our fathers, our grandfathers, didn’t talk about what happened because nobody would understand. But the thing is that you’re transformed inside. You feel different. You’ve seen things; you’ve seen death; you’ve experienced, you’ve tasted fear; you’ve done things that you don’t want to talk about or feel should be talked about because it would be too scary for people to understand.

 PTSD is one of the most common mental health conditions in the United States and I think it’s – it might be the fourth most common condition. And that’s because trauma is so prevalent in our society. About 25 percent of women experience interpersonal sexual violence, which is extraordinary. There are accidents and natural disasters. More than half of persons will be exposed to at least one traumatic event in their lives. The way that I like to describe a traumatic event is an event that kind of divides your life into a before and after, a watershed moment that really kind of changes the way you view the world. Whether or not you get post-traumatic stress disorder, it’s big. You’re leading your life a certain way, something very big happens and it changes the way that you look at yourself and you look at the world.  So those kind of events are certainly transformative.  They certainly have long-lasting marks and one of those effects of trauma exposure can be the development of post-traumatic stress disorder. Imagine if you see danger everywhere and that you’re really worried for your safety. That is going to affect almost every interaction that you have. At work, you’re going to be more on edge, more irritable. It could get you into fights with coworkers or with your employer. 

The idea that you can’t really experience pleasure or that you have restricted range of emotions is going to affect you mostly in social and in interpersonal domains. A lot of marriages have been ruined by PTSD. The spouse often really wants to help the affected person, but they’re used to a certain closeness or intimacy that they find is now more difficult to access.

The hallmark of PTSD is that the memory of the event becomes haunting. It kind of takes on a life of its own. You start thinking about what happened just out of the blue or in response to triggers in the environment. And what’s so distressing about the memory is not that you just have an image or remember what happened. You have the physiologic feeling of fear or horror that you had when the event was occurring in real time. So it’s not only a visual or verbal memory out there. It is a physiologic memory and this can happen while you’re awake. It can happen while you’re asleep in the form of your dreams. People that have PTSD have trouble experiencing pleasure and it’s all about trying to become small and not allowing yourself to be affected by the environment. It also includes really changing the way you view the world and yourself. The world’s a bad place. You might feel guilty or worthless. You might feel you’re to blame for what happened or others are to blame. And finally there are symptoms that reflect increased arousal. So people that have PTSD are on edge. Their body and brain chemistry is rigged for danger and for experiencing threat and being very, very concerned about anything in the environment that might threaten them. So the symptoms in this category include being highly reactive to startle responses, scanning the environment for signs of danger, not being able to concentrate, very irritable and angry.

Nobody’s going to wave a magic wand and say I’m going to cure you — bing, bing — and throw fairy dust on you. Getting over PTSD is going to require some hard work on the part of trauma survivors. And there’s no getting around that. It’s work to look in the mirror and know that there’s some part of you that’s gone forever. There’s work trying to understand exactly what has and hasn’t changed and what can happen next. PTSD treatment can be very, very successful and I’ve seen it do wonders for people. I’ve seen people go from being extremely symptomatic to having very low symptoms for a very long period of time. But it’s not something someone does to you. It’s not in a little pill box that you just swallow with water. It really involves confronting what has happened and sometimes feel it’s so much easier to just try to put it in the past, try to avoid it, try not to think about it, try not to deal with it. But if we open ourselves up to perhaps even the benefits or the ways that we can grow the opportunities provided to us by having these unique experiences, then you can get past that hurdle.

Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.


Dr. Rachel Yehuda is one of the foremost researchers in the country studying neurobiology with regard to PTSD. In this video interview, Dr. Yehuda relays common symptoms and struggles associated with the debilitating disorder. Where does one's brain go when traumatic flashbacks emerge? How do you fight these uncomfortable situations? Dr. Yehuda delves into these and other questions.

To boost your self-esteem, write about chapters of your life

If you're lacking confidence and feel like you could benefit from an ego boost, try writing your life story.

Personal Growth

In truth, so much of what happens to us in life is random – we are pawns at the mercy of Lady Luck. To take ownership of our experiences and exert a feeling of control over our future, we tell stories about ourselves that weave meaning and continuity into our personal identity.

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Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
Surprising Science
  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.

Ashes of cat named Pikachu to be launched into space

A space memorial company plans to launch the ashes of "Pikachu," a well-loved Tabby, into space.

GoFundMe/Steve Munt
Culture & Religion
  • Steve Munt, Pikachu's owner, created a GoFundMe page to raise money for the mission.
  • If all goes according to plan, Pikachu will be the second cat to enter space, the first being a French feline named Felicette.
  • It might seem frivolous, but the cat-lovers commenting on Munt's GoFundMe page would likely disagree.
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