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

by Bruce D. Perry

Activation of key neural networks in the brain can produce the sense of pleasure or reward. These reward circuits can be activated in multiple ways, including relief of distress (e.g., using Alcohol to self-medicate or Rhythm to regulate the anxiety produced by a stress-response system that’s been altered by trauma); positive human interactions (Relational); direct activation of the reward systems using various drugs of abuse such as cocaine or heroin (Drugs); eating Sweet-Salty-Fatty Foods (SSF foods); and behaviors consistent with your values or beliefs (Beliefs). Each day we need to fill our “reward bucket.” The darker dashed line is a minimal level of reward that we need to feel adequately regulated and rewarded; if our daily set of rewards falls below this, we feel distressed. If we get above the upper, black-dotted line, we feel fulfilled and regulated. Each of us does this in a somewhat individualized way. Many of us have opportunities for healthy rewards: lots of positive human interactions through work, worship, or volunteering that are consistent with our values and beliefs, for example (A). But a lack of strong relationships and connection can make an individual more vulnerable to overuse of other, less healthy forms of reward (B). A healthy combination of rewards (e.g., lots of positive human interactions, doing work consistent with your values, integrating healthy rhythm and sexuality into your day, staying regulated in healthy ways) can help decrease the pull...