REDIFINING PTSD TO FIT BIBICAL REALITY. Part 1

The American Psychiatric Association (APA) defines P.T.S.D. as:

"A psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury."

A psychiatric disorder is "an illness or condition that disrupts normal physical or mental functions: skin disorders | eating disorders | an improved understanding of mental disorder." When I look at myself in the mirror, I see a man diagnosed with traumatic stress looking back. Studying this subject causes me to look more profoundly than the definition from The American Psychiatric Association, Diagnostic Service Manual-5 (DSM-5), or the psychiatrists, psychologists, and counselors I've had contact with for decades. PTSD is more than an effect or a response to a one-dimensional traumatic event etc. It is multi-dimensional at its core.

I want to take the APA's definition of PTSD and add what I believe it omits, whether intentionally or otherwise. My intention is not to impugn their motives but to bring more clarity to the table for those of us who wrestle and suffer from traumatic stress.

I want to take the APA's definition of PTSD and add what I believe it omits, whether intentionally or otherwise. My intention is not to impugn their motives, but bring more clarity to the table for those of us who wrestle and suffer from traumatic stress. 

PTSD may occur in people who have experienced or witnessed a traumatic event, etc., affecting various components of the brain's limbic system, adversely, relating to the volume of the amygdala,1 the hippocampus,2 and pre-frontal cortex,3 causing "improper processing and storage of traumatic memories," . . . "recurrent memories regarding the event; traumatic nightmares; dissociative flashbacks; hypervigilance; engaging in risk-taking behavior; and an exaggerated startle response"et al, which in turn affects relationships negatively.

_________________

1 The Amygdala. This is a small almond-shaped structure located deep in the middle of the temporal lobe. The amygdala is designed to: a. Detect threats in the environment and activate the “fight or flight” response; b. Activate the sympathetic nervous system to help you deal with the threat; c. Help you store new emotional or threat-related memories. The amygdala are shown in red below. The point for the reader at this juncture is not to attempt to understand all the medical jargon. But please pay attention to the bold print. That's what you need to know. Author.

There is also evidence that amygdala volume may be negatively associated with stress and stress-response mechanisms. Exposure to high levels of chronic stress in rodents produces corticosterone-mediated spinogenesis, dendritic arborization, and hypertrophy of the amygdala (1a). One study has found that inbred recombinant mice strains with a relatively small basolateral amygdala showed a stronger conditioned fear response and corticosterone response to stress than mice strains with a large basolateral amygdala (2a). A recent study that showed reduced amygdala volume following childhood trauma suggested that severe adversity during childhood may at first enhance amygdala sensitivity through dendritic growth and synaptic connectivity, as shown in rodents (1a), but repetitive activation induces “wear and tear,” eventually resulting in a smaller amygdala in adulthood (3a). However, our amygdala results did not survive multiple comparisons corrections, and any speculations regarding the molecular mechanisms involved in reduced amygdala volume must be interpreted with caution. Further, potential confounding remains a plausible alternative explanation for the observed association. (emphasis added)

____________________

1a. Roozendaal B., McEwen B.S., Chattarji S. "Stress, memory and the amygdala." Nature Reviews Neuroscieince 10 (2009):423–433.

2a. Yang R.J., Mozhui K., Karlsson R-M., Cameron H.A., Williams R.W., Holmes A. "Variation in mouse basolateral amygdala volume is associated with differences in stress reactivity and fear learning. Neuropsychopharmacology 33 (2008):2595–2604.

3a. Veer I.M., Oei N.Y.L., van Buchem M.A., Spinhoven P., Elzinga B.M., Rombouts S.A.R.B. "Evidence for smaller right amygdala volumes in posttraumatic stress disorder following childhood trauma." Psychiatry Research 233 (2015):436–442.

2 ". . . the hippocampus has been implicated in the contextual modulation of behavior" (Maren S, Phan KL, Liberzon I., "The contextual brain: Implications for fear conditioning, extinction and psychopathology." Nature Reviews Neuroscience 14 (2013):417–428); Garfinkel S.N., Abelson J.L., King A.P., Sripada R.K., Wang X., Gaines L.M., et al. "Impaired contextual modulation of memories in PTSD: An fMRI and psychophysiological study of extinction retention and fear renewal." Journal of Neuroscience 34 (2014):13435–13443.) "With its role in fear learning and suppression of fear in safe contexts, i.e., fear conditioning, extinction, and fear renewal, the hippocampus is integral to widely accepted behavioral models of PTSD"; (Jovanovic T., Norrholm S..D., Fennell J.E., Keyes M., Fiallos A.M., Myers K.M., et al., "Posttraumatic stress disorder may be associated with impaired fear inhibition: Relation to symptom severity," Psychiatry Research 167 (2009):151–160.; Milad M.R., Pitman R.K., Ellis C.B., Gold A.L., Shin L.M., Lasko N.B., et al., "Neurobiological basis of failure to recall extinction memory in posttraumatic stress disorder." Biological Psychiatry 66 (2009):1075–1082.. 

___

Although we found an association between PTSD and hippocampus volume, there are still many unanswered questions about underlying causation. High levels of glucocorticoid receptors in the hippocampus make it particularly prone to effects of the elevated levels of glucocorticoids released in response to stress (3, 4, 5). Some magnetic resonance imaging (MRI) studies in PTSD patients also concluded that reduced hippocampal volume is a result of stress exposure. This conclusion is based on observations of reduced hippocampal volume in trauma-exposed control subjects without PTSD relative to trauma-unexposed control subjects (6,7). In contrast, other magnetic resonance imaging studies did not detect group differences between trauma-exposed and healthy control subjects (8, 9, 10), suggesting that lower hippocampal volume is specifically related to the presence of a psychiatric disorder rather than exposure to trauma. These studies are consistent with the hypothesis that lower hippocampal volume is a heritable risk factor for developing PTSD as demonstrated in twin studies. In these studies, one twin was exposed to military combat, and one was not. Of the combat-exposed individuals who developed PTSD, the unexposed twin (without PTSD) also had reduced hippocampal volume (11). (emphasis added)

_________________

3. De Kloet E.R., Vreugdenhil E., Oitzl M.S,. Joëls M. "Brain corticosteroid receptor balance in health and disease." Endocrine Reviews 19 (1998):269–301; 

4. Gould E., Tanapat P., McEwen B.S., Flügge G., Fuchs E. "Proliferation of granule cell precursors in the dentate gyrus of adult monkeys is diminished by stress." The Proceedings of the National Academy of Sciences U S A. 95 (1998):3168–3171; 

5. Sapolsky R.M., Uno H., Rebert C.S., Finch C.E. "Hippocampal damage associated with prolonged glucocorticoid exposure in primates." Journal of Neuroscience 10 (1990):2897–2902. 

6. Luo Y, Shan H., Liu Y., Wu L., Zhang X., Ma T., et al. "Decreased left hippocampal volumes in parents with or without posttraumatic stress disorder who lost their only child in China." Journal of Affective Disorders 197 (2016):223–230; 

7. Winter H., Irle E. "Hippocampal volume in adult burn patients with and without posttraumatic stress disorder." American Journal of Psychiatry 161 (2004):2194–2200; 

8. Gurvits T.V., Shenton M.E., Hokama H., Ohta H., Lasko N.B., Gilbertson M.W, et al. "Magnetic resonance imaging study of hippocampal volume in chronic, combat-related po.sttraumatic stress disorder." Biological Psychiatry 40 (1996):1091–1099; 

9. Bremner J.D., Vythilingam M., Vermetten E., Southwick S.M., McGlashan T., Nazeer A., et al. "MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder." American Journal of Psychiatry 160 (2003):924–932.

10. van Rooij S.J.H., Kennis M., Sjouwerman R., Van Den Heuvel M.P., Kahn R.S., Geuze E. "Smaller hippocampal volume as a vulnerability factor for the persistence of post-traumatic stress disorder. Psychological Medicine 45 (2015):2737–2746.

11. Gilbertson M.W., Shenton M.E., Ciszewski A., Kasai K., Lasko N.B., Orr S.P., et al. "Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma." Nature Neuroscience 5 (2002):1242–1247.

___

"An abundance of research suggests that the prefrontal cortex is central to fear processing—that is, how fears are acquired and strategies to regulate or diminish fear responses. . . . regulating the encoding of threat-related behaviors across species and the emotion of fear in humans. Furthermore, the PFC (prefrontal cortex) has a critical role in threat inhibition and extinction, as well as in processes such as emotion regulation and avoidance." Alexandra Kredlow, M., Fenster, R.J., Laurent, E.S. et al.

"Prefrontal cortex, amygdala, and threat processing: implications for PTSD." Neuropsychopharmacology. 47 (2022): 247–259. "The Prefrontal Cortex (PFC) . . . is located in the frontal lobe just behind your forehead. The PFC is designed to: a) Regulate attention and awareness; b) Make decisions about the best response to a situation; c) Initiate conscious, voluntary behavior; d) Determine the meaning and emotional significance of events; e) Regulate emotions; f) Inhibit or correct dysfunctional reactions."(emphasis added; Melanie Greenberg, "How PTSD and Trauma Affect Your Brain Functioning," Psychology Today, September 29, 2018.  (Red indicates the prefrontal cortex) 

The ventromedial PFC helps suppress negative emotions, as well as playing a role in personal and social decision-making. It also plays a major role in the latter part of memory consolidation, as well as regulating extinction—the weakening and eventual dissipation of a conditioned response.

The dorsolateral PFC modulates decision making and working memory. Working memory actively holds transitory information before it becomes part of the long-term memory during memory consolidation.

The orbitofrontal cortex, one of the least understood parts of the brain, seems to be involved in sensory integration and signaling expected rewards and/or punishments in a given situation. It also modulates emotion and decision making.

The ventromedial PFC helps suppress negative emotions, as well as playing a role in personal and social decision-making. It also plays a major role in the latter part of memory consolidation, as well as regulating extinction—the weakening and eventual dissipation of a conditioned response.

The Mid-Anterior Cingulate Cortex12

The primary function of the mid-anterior cingulate cortex (ACC) is to monitor conflict. The ACC also plays a role in:

• Emotional awareness (particularly empathy)

• Registering physical pain

• Regulating autonomic functions like heart rate and blood pressure (Erin Maynard, "How Trauma and PTSD Impact the Brain," Verywell mind, February 13, 2020.)

This cursory look at the effects on various brain components in our limbic system originates with continual and prolonged stress.

It's a given that most psychologists and psychiatrists are atheistic, materialistic evolutionists. What they see around them is all there is. Their purpose is to make the place better than they found it and survive as long as possible, enjoying the stops along the way. Thus, evolutionists base their existence on a theory- a fact for evolutionists- that we all evolved from lower life forms to higher life ones. When they die, it's over for them. When they look back, life is about their survival, a one-dimensional existence. For them, here and now is all there is. It is, however, the fool that has said in his heart, "There is no God" (Ps. 14:1). Atheistic, materialistic evolutionists have the road map that suits them. Barring any intervention by God that doesn't exist for them, they will die in their sins and face the relentless justice and wrath of God.

But for the Christian, life is multi-dimensional, transcending physical matter or the laws of nature. Since God exists, which all men know intuitively, mankind has been created in His image (Gen. 1:26-27; Rom. 1:18ff).

Knowing that the former perspective does not square with the truth of the Bible, I ask, how did God initially create man's brain when sin and war didn't exist? Genesis 1 - 2 indicates that man had no need of a brain prepared for war. He lived in perfect harmony with his Maker, his neighbor, and the creation.

________________

12. Charles Hodge, A Commentary on the Epistle to the Ephesians (Grand Rapids: Wm. B. Eerdmans Publishing Co., 1954), 265-66, in Robert L. Reymond, A New Systematic Theology of the Christian Faith (pp. 627-628). Thomas Nelson. Kindle Edition.

___

God had written His law on man's heart, and although man sinned in Adam (Rom. 5:12ff; 1 Cor. 15:45-47), man, the corrupted sinner, cannot escape the knowledge of God no matter how hard he tries. 

Rom. 1:18-23 For the wrath of God is revealed from heaven against all ungodliness and unrighteousness of men who suppress the truth in unrighteousness, 19 because that which is known about God is evident within them; for God made it evident to them. 20 For since the creation of the world His invisible attributes, His eternal power and divine nature, have been clearly seen, being understood through what has been made, so that they are without excuse. 21 For even though they knew God, they did not honor Him as God or give thanks, but they became futile in their speculations, and their foolish heart was darkened. 22 Professing to be wise, they became fools, 23 and exchanged the glory of the incorruptible God for an image in the form of corruptible man and of birds and four-footed animals and crawling creatures.

We have seen that within the systems and components of the limbic system, memory of the events of our lives is processed and stored. We could not remember what "Incoming!" means without these systems. We would need to remember the difference between the sound an AK-47 makes as opposed to the M-16 (for us Vietnam veterans). Make sense? So, something happened between Adam giving into temptation and God's pronouncement of the mitigated curse to enable him to possess some ability to connect certain sounds with danger for survival. 

This writer believes that, although not stated explicitly in Scripture, the clear implication of the adverse effects of the curse of God on man is that man's brain had to undergo some physical change to survive a rapidly deteriorating and dangerous world. Note what our Lord Jesus stated on the mountain during His Sermon, Mt. 5-7. 43 “You have heard that it was said, ‘You shall love your neighbor and hate your enemy.’ 44 But I say to you, love your enemies and pray for those who persecute you, 45 so that you may be sons of your Father who is in heaven; for He causes His sun to rise on the evil and the good, and sends rain on the righteous and the unrighteous (Mt. 5).

If we unpack these verses, Jesus states that for all men, it is impossible for man from within himself to love his enemies. No, you kill the enemy before he kills you. Jesus, the greater Moses, lays down the law, crushing everyone it encounters. The Jews understood. Every Gentile, specifically the Romans, you hated. This saying comes straight from Jewish tradition, not the heart of God in His law. Lev. 19:18 You shall not take vengeance, nor bear any grudge against the sons of your people, but you shall love your neighbor as yourself; I am the Lord. (emphasis added)

Jesus is saying that I, the Lord God, demand that you love your neighbors. God meets any infraction of this direct command with divine justice (at some point). Let's take this a step further. All men since Genesis 3 are born God's enemies, born alienated from God, and corrupt. God sent Jesus to:

1. Be born a man.

2. 2.Reveal God's loving nature to men who hate Him.

3. 3. Show that love in practical terms by sending the sun to shine on the evil and good ones and sending rain on the evil and good.

In this way, God has demonstrated that what is impossible for man, loving one's enemies, is possible only through Christ's perfect obedience. In other words, only God can perfectly obey God's commands. With man, such obedience is impossible.

Let's take this one step further. God shows His mercy to all of us wicked, sin-polluted folks in another way. In war, there is God's elect, the good meaning just, and God's enemies in each army. God has enabled both sides to remember the sights, sounds, and smells of battle. God has, therefore, established a means of survival for combatants who participate in taking men's lives. PTSD thus becomes a means by which good men and evil men survive. Think about all the Nazis SS that survived the war. How did men like Joseph Stalin, Mao, or Pol Pot, being wicked, live past their first atrocity in a moral universe? Think equally of the Christians who survived. The sun rose on both categories of men, as did the rain purely from God's mercy. (I don't want to get into the existence of evil if a good God exists here. Although, Acts 2:22-23 . . . just as you yourselves know— 23 this Man, delivered over by the predetermined plan and foreknowledge of God, you nailed to a cross by the hands of godless men and put Him to death; and Acts 4:27 For truly in this city there were gathered together against Your holy servant Jesus, whom You anointed, both Herod and Pontius Pilate, along with the Gentiles and the peoples of Israel, 28 to do whatever Your hand and Your purpose predestined to occur, must be considered. God is the sovereign lawgiver and man is responsible for his wicked deeds.)

How long has man been at war with himself? The answer to that question for current researchers is how one defines war. Two UK professors, Martin Smith, and John Stewart, have stated, “To an extent, this question has been resolved by several examples of mass killing, where whole communities were massacred and buried together at a number of European sites dating to the Neolithic period (about 12,000 to 6,000 years ago, when agriculture first emerged).” (emphasis theirs) The problem now becomes how to define war. Is war murder? Is it justice? “However, in such societies, acts of warfare also commonly involve a single individual being ambushed and killed by a coordinated group.” How would an outsider view such proceedings?

Smith and Stewart wonder whether Neanderthals who committed violent acts “were capable of conceptualizing ‘war’ in the way it is understood by modern human cultures,” believing it debatable. What Smith and Stewart believe: “On the bigger question of whether modern humans were responsible for the extinction of Neanderthals, it’s worth noting that Neanderthals in many parts of Europe seem to have gone extinct before our species had arrived. This suggests modern humans can’t be completely to blame, whether through war or competition.

“However, what was present throughout the period was dramatic and persistent climate change that appears to have decreased the Neanderthals’ preferred woodland habitats.” (emphasis theirs) Their conclusion is in the subjunctive mood, “we can’t say this behaviour was responsible or even necessary for the disappearance of Neanderthals. They may have simply been the victims of the natural evolution of our planet.” (Martin Smith and John Stewart, “When did humans first go to war?” The Conversation, Updated November 9, 2020. https://theconversation.com/when-did-humans-first-go-to-war-149637 (accessed January 27, 2022)).

Answering the question as to why men kill each other is hardly ever addressed, as in this article. God forbid that anyone from the field of science should suggest war begins in the heart because man is a sinner. How unscientific!

Jonathan Strickland answers the question about the date of the first war, “(T)he earliest conflicts likely began 10,000 years ago in the late Paleolithic or early Neolithic periods, but we have no records from that time.” (Jonathan Strickland, “When and why did we invent war?” howstuffworks. https://science.howstuffworks.com/invent-war.htm (accessed January 27, 2022).

The website wonderopolis.com asked this question, “How Long Have There Been Wars?” Their findings reveal, “At a site known as Cemetery 117, archeologists have uncovered a large group of bodies with arrowheads lodged in their bones, which leads experts to believe they were the victims of a large battle. The remains have been dated to the Mesolithic era, over 13,000 years ago.” Furthermore, Washington’sblog.com informs us that “America Has Been At War 93% of the Time – 222 Out of 239 Years – Since 1776.”

Few of these sources agreed statistically. Here are the numbers and dates so you can decide. According to Barnes, pacifism was taught from “the period of time right after the beginning of the church up to about the end of the second century.” Another source testifies to a battle that occurred between 4,000 and 3,500 B.C. in what is now north-eastern Syria. The Uruks attacked the city of Hamoukar and the city-state surrounding it in southern Mesopotamia. We have seen that India fought wars and suffered the effects of 5,000 years before Christ.

John Keegan, a distinguished British military historian, stated in War and Civilization, “War is an activity probably about 5,000 years old in man's life on earth.” Keegan missed the memo on Cemetery 117. According to one website, the first war recorded was in Sumer (modern Iraq) and Elam, currently part of southern Iraq and ancient Mesopotamia. This war occurred ca. 2700 B.C. However, well-intentioned military historians rely on their intellect and “recorded” history to arrive at some form of the truth about general combat.13

__________________

13Keegan, John. “War and Civilization First Blood.” Ancient History. Youtube. https://www.bing.com/videos/search? q=War+and+Civilization+1&&view=detail&mid=A3E3F9AE113A33D0568BA3E3F9AE113A33D0568B&FORM=VRDGAR (accessed August 19, 2017).)

___

Of the three writing systems, only the earliest, the Mesopotamian cuneiform script, was invented in Sumer, present-day Iraq, c. 3200 B.C. Scholars can trace this script from a prehistoric antecedent to its present-day alphabet without any discontinuity for 10,000 years. Scientists had divided the evolution of writing into four recording phases: (a) clay tokens represented units of goods used for accounting (8000–3500 BC); (b) the three-dimensional tokens were transformed into two-dimensional pictographic signs, and like the former tokens, the pictographic script served exclusively for accounting (3500–3000 BC); (c) phonetic signs, introduced to transcribe the name of individuals, marked the turning point when writing started emulating spoken language, and, as a result, became applicable to all fields of human experience (3000–1500 BC); (d) with two dozen letters, each standing for a single sound of the voice, the alphabet perfected the rendition of speech. After ideography, logography, and syllabaries, the alphabet represents a further segmentation of meaning.

Written battlefield records may have existed since the invention of language, dating writing to the time of man’s creation in some form. According to the Canadian Army Journal, a former president of the Norwegian Academy of Sciences, aided by historians from England, Egypt, Germany, and India, came up with some fascinating figures and early discoveries written about war.

The Norwegian Academy discovered that the world had known only 292 years of peace since 3600 B.C. For over 5,600 years, armed conflict, the Academy believed, has occurred somewhere in the world. Of the approximate 14,500 recorded wars, large and small, a staggering 3,640,000,000 people have died as a result. The economic value of the destruction of those wars would pay for a solid gold belt around the world, 25,000 miles around, almost 100 miles wide, and about 33 feet thick.

Individuals, states, or political factions have gained sovereignty over regions through war throughout history. The history of one of the earliest civilizations globally, Mesopotamia, chronicled nearly constant strife. Even after Sargon the Great of Akkad (2334-2279 B.C.) unified the region under the Akkadian Empire, that nation waged war by putting down rebellions or fending off invaders. The Early Dynastic Period of Egypt (3150-2686 B.C.) rose from war when the Pharaoh Manes (or Menes) of southern Egypt conquered the northern region of Egypt (though scholars dispute this claim). In China, the Zhou Dynasty gained ascendancy through battle in 1046 B.C. The conflict of the Warring States Period (476-221 B.C.) reached a resolution when the State of Qin defeated the other contending states in battle, unifying China under the rule of emperor Shi Huang-ti. 

This same violent pattern has held for other nations throughout time. Historians cite the success of Scipio Africanus (236-183 B.C.) in his defeat of Carthage (and so the ascendancy of Rome) or Philip II of Macedon (382-336 B.C.), who united the city-states of Greece. Opposing nations have historically settled political disputes on the battlefield. The Bible is historically accurate and states that man has been at war since Cain killed his brother, Abel.