Let us examine through the lens of modern medicine how painful memories leave lasting traces in our brain and body. Post-traumatic stress disorder (PTSD) is more than an emotional wound; it involves complex changes across brain structure, function, and the overall hormonal system. Just as Donguibogam described restlessness of the spirit and disruption of qi, modern science explains these phenomena through specific brain regions and neurotransmitter imbalances.
First, in patients with PTSD, the amygdala is often excessively activated. The amygdala is a core brain structure that detects threats and processes fear responses. Following trauma, it sounds alarms even at minor stimuli, maintaining a perception of constant danger. This produces hyperarousal, marked by being easily startled, perpetually tense, and hypervigilant. Conversely, the function of the prefrontal cortex, which governs emotional regulation and cognitive function, tends to decline. When this region functions poorly, suppressing excessive fear responses from the amygdala becomes difficult, leading to elevated anxiety and impulsivity.
In addition, reductions in the volume or function of the hippocampus, which handles memory processing, have been reported. The hippocampus organizes the context and chronology of events to store them as normal memories. However, traumatic memories are so overwhelming that they bypass normal hippocampal processing, remaining fragmented or stored as vivid sensory memories. This explains why individuals experience flashbacks or nightmares, where sensations and emotions from that moment re-emerge vividly as if the past event were occurring again right before their eyes.
The body's stress response system, the hypothalamic-pituitary-adrenal axis, also plays an essential role. Under severe stress, the hypothalamic-pituitary-adrenal axis is activated to secrete the stress hormone cortisol. In chronic PTSD, cortisol secretion often becomes abnormal. In some cases, excessive secretion induces anxiety and insomnia, while in others, a blunted stress response deepens lethargy and depression. Donguibogam's assertion that fear injures the kidney closely aligns with this chronic disruption of the hypothalamic-pituitary-adrenal axis, reflecting impairment of the body's foundational energy and regulatory capacity.
These changes in the brain and hormonal systems lead to neurotransmitter imbalances. Noradrenaline, which amplifies anxiety and fear, is excessively secreted, while serotonin, which regulates mood and well-being, tends to become deficient. Furthermore, decreased function of gamma-aminobutyric acid, an inhibitory neurotransmitter, leaves the brain prone to excitation and unable to settle.
Promisingly, the brain possesses remarkable neuroplasticity. This means that through appropriate treatment and deliberate effort, neural networks can be reorganized and function can be restored. While painful past memories cannot be erased entirely, one can alter how the brain processes those memories, helping it store them separately from safe present circumstances. Just as Donguibogam sought to restore tranquility by steadying the shaken spirit, modern medicine provides a pathway to regain peace by rebalancing the brain and body. An integrative approach aimed at fundamental recovery, rather than mere symptom suppression, is therefore vital.
