The repercussions were profound. For the first week after the abduction, “I felt like a newborn baby”, Ebaugh says, “like I had to be held, or at least be in the presence of somebody”. She shivered constantly, was easily startled and felt only fear. She could not go near the grocery store.
Nearly every trauma victim experiences PTSD symptoms to some degree. Many people who are diagnosed with the disorder go on to have severe depression, substance-abuse problems or suicidal thoughts. PTSD can take a horrific toll. Between 2005 and 2009, as a growing number of soldiers faced multiple deployments in Iraq and Afghanistan, suicide rates in the US Army and Marines nearly doubled.
Over the past two decades, researchers have used various kinds of imaging techniques to peer inside the brains of trauma victims. These studies report that in people with PTSD, two areas of the brain that are sensitive to stress shrink: the hippocampus, a deep region in the limbic system important for memory, and the anterior cingulate cortex (ACC), a part of the prefrontal cortex that is involved in reasoning and decision-making. Functional magnetic resonance imaging (fMRI), which tracks blood flow in the brain, has revealed that when people who have PTSD are reminded of the trauma, they tend to have an underactive prefrontal cortex and an overactive amygdala, another limbic brain region, which processes fear and emotion (see 'The signature of stress').
People who experience trauma but do not develop PTSD, on the other hand, show more activity in the prefrontal cortex. In August, Kerry Ressler, a neuroscientist at Emory University in Atlanta, Georgia, and his colleagues showed that these resilient individuals have stronger physical connections between the ACC and the hippocampus. This suggests that resilience depends partly on communication between the reasoning circuitry in the cortex and the emotional circuitry of the limbic system. “It's as if [resilient people] can have a very healthy response to negative stimuli,” says Dennis Charney, a psychiatrist at the Mount Sinai School of Medicine in New York, who has conducted several brain-imaging studies of rape victims, soldiers and other trauma survivors.
After her abduction, Ebaugh began seeing a psychotherapist and several alternative-medicine practitioners. But more than anything else, she attributes her resilience to being surrounded by caring people — beginning within minutes of her escape.
After Ebaugh crawled up the rocky riverbank, a truck driver picked her up, took her to a nearby convenience store and bought her a cup of hot tea. Police, when they arrived, were sympathetic and patient. The doctor at the hospital, she says, treated her like a daughter. A close friend took her in for a time. And her family offered reassurance and emotional support. “For the first month, I almost had to tell people to stop coming because I was so surrounded by friends and community,” she says.
Studies of many kinds of trauma have shown that social support is a strong buffer against PTSD and other psychological problems. James Coan, a psychologist at the University of Virginia in Charlottesville, has done a series of experiments in which women lie in an fMRI scanner and see 'threat cues' on a screen. They are told that between 4 and 10 seconds later, they may receive a small electric shock on the ankle. The cue triggers sensory arousal and activates brain regions associated with fear and anxiety, but when the women hold the hands of their husbands or friends, these responses diminish.
Social interactions are complex and involve many brain circuits and chemicals; no one knows exactly why they provide relief. Being touched by someone is thought to stimulate the release of natural opioids, such as endorphins, in the brain. The ACC is packed with opioid receptors, suggesting that touch could influence its response to stress.