Matt Ball blog: “Evidence and narratives – can they share the space?”

By February 23, 2018 No Comments

Session 2: Impacts of Trauma

Thursday, February 22, 2018

11:15 AM – 12:45 PM


Evidence and narratives – can they share the space?

We have arrived at the time when a skilful person can deliver comprehendible expert summary on neurobiology of trauma, in half an hour, to a non-neuroscience mind like mine – This is a break through! If you are unsure of what such things as dorsal anterior cingulate, insular cortex, Ventromedial prefrontal cortex, Hippocampal function or Impaired pre-frontal inhibition might mean, you are likely to be in the majority. But today, Kim Felmingham skilfully introduced us to these parts of the brain and the how research conceptualises trauma though the neurobiology lens.

With this foundation, Martin Dorahy invited us to consider the research on childhood trauma, dissociation and the experience of hearing voices. In research data, there is potentially different types of dissociation, and confirmation that voice hearing is trans diagnostic and that people who do not have a diagnosis also hear voices. We also heard a rationale and potential value, from a research perspective, to some of the age-old questions that are asked about voices being internal or external. These questions have been asked through a diagnostic systems lens for many years to show…well to show that clinicians can ask questions, they often have not done anything with the responses they receive form voices hearers. Today the data is showing that the phenomena of voices and the type of dissociative experience may be understood a little and may have some value, through asking such questions.

The evidence identifies that different trauma has an impact at different ages, effects the brain in different regions, triggers different mechanism and effects the likely presentation of trauma in different ways. We also learned that different people hear voices in different ways and that there may be differences in different disorders.

So, what does that tell us about the story a person might want to have witnessed through the use of their narrative? In truth, I’m not sure it tells us too much and here is my reason for saying that.  Research continues to be landed in the diagnostic and illness-based system: Not a criticism of research per ce, but it through a trauma informed lens it does not overtly seek to the hear uniqueness of the individual and their narrative, their voices, by the nature of it being based within a classification system.

Trauma, and the narratives that are formed in response to trauma, are unique to a person as Prof Millburn referred to earlier today. The value of research is understood in the current system and current discourse, but trauma informed approaches are unique and attuned to the individual – that is just a truth and does not require too much research: we know this if we witness a person and the telling or their narrative.  As such, I reflected on whether we could undertake and document more research that hears the narratives of the person and invite understanding of the impact of brain changes and the presence of voices through the combined narrative. Perhaps even a broad range of research that places the narrative and empowerment of the persons own personal story as central. This could influence the practice and attitude of people witnessing a person who has experienced trauma, and dove tailed with the research we heard today, we could step into brave new worlds of understanding?

Can empirical evidence and narrative share a space – Perhaps, with a broader facilitation of trauma informed principle and values in attitude and action of ‘professionals’    

By Matthew Ball

Nurse Practitioner Candidate

Southern Adelaide Local Health Network