What Happened to You?: Conversations on Trauma, Resilience, and Healing

by Bruce D. Perry

Am I enough? Am I worthy? Am I deserving or lovable? Not one baby in the earliest moments of awareness asks, “Do I matter?” Their world is a place of wonder. But with their very first breaths, these tiny human beings begin trying to make sense of their surroundings. Who will nurture and care for them? What will bring comfort? And for so many little ones, life begins to take its toll, with violent eruptions by the caregiver or simply the lack of a soothing voice or a gentle touch. In our first encounters, our human experiences diverge.

What I’ve learned from talking to so many victims of traumatic events, abuse, or neglect is that after absorbing these painful experiences, the child begins to ache. A deep longing to feel needed, validated, and valued begins to take hold. As these children grow, they lack the ability to set a standard for what they deserve. And if that lack is not addressed, what often follows is a complicated, frustrating pattern of self-sabotage, violence, promiscuity, or addiction.

I’ve found that a “brain-aware” perspective helps me when I’m trying to understand people.

Each of us creates a unique worldview shaped by our life’s experiences.

The sense of self informs every relationship or decision we make as we move through life. And when children don’t feel respected by the decisions of their parents, their beliefs about how they are valued are crushed.

Fear shuts down thinking and amps up feeling,

When we meet someone, we form a first impression (“He seems like a really nice guy”), frequently with no apparent information on which to base it. This is because attributes of the person evoke in us something we’ve previously categorized as familiar and positive. The opposite can happen (“This guy is a complete jerk”) if some attribute taps into a previous negative experience.

The brain is a meaning-making machine, always trying to make sense of the world. If our view of the world is that people are good, then we will anticipate good things from people. We project that expectation in our interactions with others and thereby actually elicit good from them. Our internal view of the world becomes a self-fulfilling prophecy; we project what we expect, and that helps elicit what we expect.

We elicit from the world what we project into the world; but what you project is based upon what happened to you as a child.

Remember: Relief of distress gives pleasure. They are relaxed for the first time in their lives. The pull to go back and use again is very powerful, though it’s affected by how dysregulated you are, and by the nature and strength of the other sources of reward in your life.

This is why a developmentally informed, trauma-aware perspective is so important for all of our systems impacted by or dealing with substance use and dependence—education, mental health, health, law enforcement, juvenile and criminal justice, family courts. It is impossible to find any part of our society where this is not an issue. We have such good intentions, and we have good people, and we’re spending a lot of money, but we’re ineffective because we are not understanding the underlying mechanisms that make someone vulnerable to chronic substance use.

It comes back to dysregulation. There’s always a pull to regulate, to seek comfort, to fill that reward bucket. But it turns out that the most powerful form of reward is relational. Positive interactions with people are rewarding and regulating.

This principle of “specificity” applies to all brain-mediated functions, including the capacity to love. If you have never been loved, the neural networks that allow humans to love will be undeveloped, as in Gloria’s case. The good news is that with use, with practice, these capabilities can emerge. Given love, the unloved can become loving.

Really, every aspect of human functioning is influenced by early developmental experiences—both when there are consistent, predictable, and loving interactions and when there is chaos, threat, unpredictability, or lack of love.

our specific trauma-related responses will depend upon the stress response that was dominant in any given experience. It is possible for one person to have multiple evocative cues that elicit very different behavioral responses.

Consider, say, a fire at an elementary school. A veteran firefighter can walk right up to the flames and put them out, business as usual. In contrast, a first-grader witnessing his classroom burst into flames will experience minutes of intense fear, confusion, and helplessness. This illustrates one of the key issues in understanding a potentially traumatic event: How does the individual experience the event?

So we have three people in the same event, each experiencing it differently. And because each experienced it differently, each had a different stress response.

But I believe trauma can also arise from quieter, less obvious experiences, such as humiliation or shaming or other emotional abuse by parents,

Meaning, the more adversity you had in childhood, the greater your risk for health problems. Subsequent studies using the same data demonstrated similar correlations between an adult ACE score and risk for suicide, mental health problems, substance use and dependence, and a host of other problems.

If, in the first two months of life, a child experienced high adversity with minimal relational buffering but was then put into a healthier environment for the next twelve years, their outcomes were worse than the outcomes of children who had low adversity and healthy relational connection in the first two months but then spent the next twelve years with high adversity.

You can stand the emotional intensity of visiting the wreckage of your trauma-fractured life for only a few seconds before your brain starts to do things to protect you from the pain.

Think about how you’ve handled difficulty in your own life. With things that are very hard to deal with, you don’t want to talk about the pain or loss or fear for forty-five minutes nonstop. You want to talk with a really good friend for maybe two or three minutes about some aspect of it. When it gets too painful, you step back, you want to be distracted. And maybe you want to talk more later on. It is the therapeutic dosing that really leads to healing. Moments. Fully present, powerful but brief.

Often when a traumatic event takes place, it is so threatening and so far outside our usual experience that it doesn’t fit our working model of the world.

Trauma leaves you shipwrecked. You are left to rebuild your inner world. Part of the rebuilding, the healing process, is revisiting the shattered hull of your old worldview; you sift through the wreckage looking for what remains, seeking your broken pieces. Dreams, intrusive images of the trauma, and reenactment play are your mind struggling to make sense of your new reality. As you revisit the shipwreck, piece by piece, you find a fragment and move it to your new, safer place in the now-altered landscape. You build a new worldview. That takes time. And many visits to the wreckage.

In some ways, avoidant behaviors are an attempt to regain control over what feels like the uncontrollability of the traumatic experience. You may also recall that avoidance is part of a dissociative response to a threat

when the abuse or trauma took place within the context of early caregiving relationships. If a child was abused in the context of an intimate relationship (by a parent, for example), they will find intimacy—emotional and physical closeness—threatening. They will often long to be connected but find themselves anxious, confused, or overwhelmed when they get close to someone. They will avoid intimacy in a relationship; if intimacy can’t be avoided, they will sabotage or undermine the relationship.

There are complex traits, such as altruism, that require genetic superstructure, but how we incorporate that into the complex beliefs and practices of Buddhism or Christianity or Islam is not genetic. There may be genetic elements to being wary or defensive when interacting with someone very different from your family or clan of origin, but racism is a learned set of beliefs about the superiority of a people, and racism in practice is about power, dominance, and oppression.

In contrast, other people appear to be born with a “sensitive” stress response. They are more easily overwhelmed by minor shifts in sensory complexity. Sometimes these people have what’s referred to as a “difficult to soothe” temperament noticeable at birth.

The study of epigenetics is still very young, and there is much more to learn,

One of the most important areas is the way we connect with others. Developmental trauma can disrupt our ability to form and maintain relationships. Whenever trauma or neglect takes place in the context of our caregiving relationships, there’s a high risk that the neural networks involved in reading and responding to other people will be altered. When these “attachment” capabilities are impaired, there will be difficulties with friendships, school, employment, intimacy, and family;

Dismissive caregiving can lead to an unquenchable thirst for love. You cannot love if you have not been loved.

Our current public education system is good at producing workers, but it can be a miserable place for creators, artists, and future leaders.

Therapy is more about building new associations, making new, healthier default pathways. It is almost as if therapy is taking your two-lane dirt road and building a four-lane freeway alongside it. The old road stays, but you don’t use it much anymore.

The privileged groups turn their gaze from the pain. In the face of systemic racism, we say, “Look how far they’ve come”; in the face of cultural genocide, “They need to assimilate”; in the face of trauma, “Isn’t it great that they are resilient.” It is so easy to create an “other.” Us-and-them is deeply ingrained in our neurobiology; it’s what makes connectedness a double-edged sword.

We can help each other heal, but often assumptions about resilience and grit blind us to the healing that leads us down the painful path to wisdom.

Adversity impacts the developing child. Period. What that impact will be, when it may manifest, how it may be “buffered”—we can’t always say. But developmental trauma will always influence our body and brain.

Later, they’ll crawl away from the safety of their parent and start exploring the world; because this is novel, it will activate their stress response—but only moderately. When it becomes too much, they’ll crawl back to the “safe base.” This process—leave the safe, explore the new, return to the safe—will continue thousands of times for the toddler and young child.

Finding the “just right” is a major issue with children who have had trauma. Remember, they frequently live in a persistent state of fear. And fear shuts down parts of the cortex—the thinking part of the brain.

if someone has a life with chaotic, uncontrollable, or extreme and prolonged stress, particularly early in life, they’re more likely to act before thinking. Their cortex is not as active, and reactivity in the lower areas of the brain becomes more dominant.

Yes, it’s best if you can simply be present. If you do use words, it’s best to restate what they’re saying; this is called reflective listening. You can’t talk someone out of feeling angry, sad, or frustrated, but you can be a sponge and absorb their emotional intensity. If you stay regulated, ultimately they will “catch” your calm.

how you can help a dysregulated person feel more regulated. Instead of saying, Hey, tell me what you’re thinking about, you need to let them control when and how much they’re going to talk about what’s upsetting them. If you give a person that control and help them feel safe, in their own time they will be more capable of talking.

For someone with relational poverty, these stressful experiences are magnified by the echo chamber of their own head. Stress becomes distress. And distressing experiences become sensitizing, resulting in the same physical and mental effects as trauma.

We’ve talked about how individual people develop their unique “worldview”—well, the same thing happens with systems and organizations; they develop a dominant perspective. In the past, most of these perspectives have not included any significant understanding of development, stress, or trauma—or interrelated issues that can cause distress or trauma such as implicit bias, racism, and misogyny.

A child who is struggling is not going to say, “This poor teacher simply doesn’t understand ‘state-dependent’ functioning and the impact of trauma on my ability to learn. He should be helping me regulate, not conjugate.” They say, “I must be dumb.”

Our ancestors recognized the importance of connectedness and the toxicity of exclusion. The history of the “civilized” world, on the other hand, is filled with policies and practices that favored disconnection and marginalization—that destroyed family, community, and culture.

And even though the dissociation is adaptive, it results in more passivity and compliance, making traumatized peoples easier to dehumanize and exploit.