“The compulsion to repeat the past through traumatic re-enactments or engaging in reckless behaviours is frequently one of the few ways that allows traumatized individuals to ‘feel alive’. It is well known that individuals with PTSD – particularly when associated with developmental trauma – often report a sense of self that does not exist entirely, illustrated eloquently through statements, such as, “I do not know who I am,” or, “I feel like I have stopped existing.”
Research suggests that these experiences may relate, in part, to the reduced functional connectivity of the default mode network, a brain network critical to the experience of a sense of self, observed during rest among individuals with PTSD. Critically, however, enhanced default mode network connectivity has recently been observed when individuals with PTSD are triggered by reminders of their trauma, suggesting that the sense of self may ‘come alive’ under conditions of threat and terror. It is therefore possible that some individuals with PTSD may seek situations involving threat or terror in order to experience of a semblance of a sense of self and a related sense of agency, which may be lacking in the absence of extreme hyperarousal states. Ruth will focus on how we can work clinically to help traumatized individuals ‘feel alive’ and safe without engaging in traumatic re-enactments and/or reckless behaviour.”