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

by Bruce D. Perry

Frustration, anger, and fear can shut down parts of the cortex. When someone is dysregulated, they simply cannot use the smartest part of their brain.

STATE DEPENDENCE AND MEMORY STATE DEPENDENCE AND ACCESS TO ‘NARRATIVE’ MEMORY In a fear state (dysregulated), there is a “shutdown” of some of the systems in higher areas of the brain (e.g., cortical). This makes retrieval of previous linear narrative memory inefficient; a common example of this is test anxiety. The content has been stored, but in the moment (e.g., during the test), retrieval is not possible. When the person is regulated, and feeling connected and safe, the stored content is accessible and easier to retrieve.

The Still-Face paradigm shows viscerally that within seconds of a child perceiving their parent to be disengaged and emotionally absent, they start to feel distress and attempt to reengage the parent. But when these efforts fail, the infant disengages and emotionally withdraws. Imagine the impact on a developing child if that is a continuous experience. A cold, disengaged, partially attentive caregiver can have immediate, and potentially lifelong, toxic effects on the developing child. This child may grow up feeling inadequate, unlovable. Even with many gifts and skills, they will feel they are “not enough” as an adult, and that can lead to a host of maladaptive behaviors including unhealthy forms of attention seeking, self-sabotaging, or even self-destructive behavior.

Without dissociation, the more a person is threatened, the more fearful they become, and the more the cortex shuts down.

Cutting can be very confusing from the outside. We’ve talked about how your stress-response systems can become overly reactive, how anyone experiencing inescapable and unavoidable trauma will dissociate—and how, if the pattern of this trauma is prolonged or extreme, the dissociative systems become sensitized: overactive and overly reactive. Remember that dissociation releases opioids (enkephalins and endorphins), your own painkillers. If a person without a sensitized dissociative response cuts themselves, their body releases a little bit of these opioids so that they can tolerate the cut; the amount released would be pretty small and proportional to the little cut. But when someone with a sensitized—overly reactive—dissociative response cuts themselves, they release a lot of opioid. It’s almost like taking a little hit of heroin or morphine.

The key point is that all of us tend to gravitate to the familiar, even when the familiar is unhealthy or destructive. We are drawn to what we were raised with.

if as a child you’ve experienced chaos, threat, or trauma, your brain organizes according to a view that the world is not safe and people cannot be trusted.

we feel better with the certainty of misery than the misery of uncertainty. Good or bad, we are attracted to things that are familiar.

when one of my girls meets a young man who really is going to respect her, she automatically thinks something’s wrong with him. And as you say, she does things to provoke him; in effect, she sabotages the relationship to get him to treat her the way she’s accustomed to being treated—to get him to leave. Like Maya Angelou always said, “You teach people how to treat you.”

The children and adults we work with are so used to chaos, they actually feel more comfortable when it’s chaotic than when it’s calm. So when they get into a classroom or a new foster home where people are predictable and consistent and thoughtful, it makes them feel uncomfortable. Little by little, they get more and more uncomfortable until they provoke a predictable response. I have teachers and foster parents tell me, “He almost acts like he wants to get punished.” And, to a certain extent, they’re right. He is seeking a predictable response from the world. And predictable, for him, means being punished, excluded, minimized. He is looking for evidence that his worldview is accurate: The world is chaotic. People aren’t trustworthy. I don’t belong. He is trying to be kicked out of this class. He is seeking to get kicked out of your home. When we start our work, we try to teach the adults what this behavior really means, and how they can recognize it so they don’t reenact it.

We often use our belief in another person’s “resilience” as an emotional shield. We protect ourselves from the discomfort, confusion, and helplessness we feel in the face of their trauma. It’s a kind of looking away; it lets our worldview go unchallenged and lets our life continue with minimal disruption.

The process you’re describing will be very different if the child is in a home where there’s been nothing but chaos or a lack of dependability. I’m thinking of all the people we encounter who are ready to fight the minute you say anything they feel is critical or confrontational; the slightest thing, and they’re ready to blow.

Our brain processes incoming sensory input from the bottom up (see Figures 2 and 10), and 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.

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. It also helps to use some form of rhythmic regulating activity to keep yourself regulated while you’re doing this—like taking a walk, kicking a ball back and forth, shooting some baskets, coloring side-by-side; there are dozens of rhythmic ways to help us regulate.

His stress-response system, including his CRNs, was overactive and overly reactive. That made it hard for him to fall asleep. And when he did, his sensitized stress-response system made it hard to transition smoothly through the various stages of sleep.

But now he was telling me that he had a long, deep, refreshing sleep after hours of dancing and that he fell asleep in minutes when he was getting a massage.

month or so after creating a more structured schedule of rhythmic activities, he began sleeping much better. And his other post-traumatic symptoms started to be less intrusive.

I started to understand that most therapeutic experience—most healing—happens outside of formal therapy. Most healing happens in community.

believe that if you don’t recognize the built-in biases in yourself and the structural biases in your systems—biases regarding race, gender, sexual orientation—you can’t truly be trauma-informed. Marginalized peoples—excluded, minimized, shamed—are traumatized peoples, because as we’ve discussed, humans are fundamentally relational creatures. To be excluded or dehumanized in an organization, community, or society you are part of results in prolonged, uncontrollable stress that is sensitizing (see Figure 3). Marginalization is a fundamental trauma.

This is the start of a toxic mismatch between the child’s capabilities and the unrealistic expectations of an education system that is all too often underresourced, developmentally uninformed, and trauma-ignorant. Even if the child “progresses” to the next grade, they are still behind, and this sets them up to fail. Year after year, they fall further and further behind. Their delays in developing skills, together with their trauma-related symptoms, begin to attract mental health labels (see Figure 6). The hypervigilance from their sensitized stress response is labeled ADHD; their predictable efforts to self-regulate—by rocking, chewing gum, doodling, daydreaming, listening to music, tapping their pencil, etc.—are prohibited. They will be labeled, medicated, excluded, punished, perhaps expelled, and then, all too often, arrested. When they try to avoid the constant humiliation of school, they’re charged with truancy; when they try to flee and the school staff tries to stop them, a restraint incident results in charges of assault—against the child. This is the school-to-prison pipeline.

The therapeutic web is the collection of positive relational-based opportunities you have throughout your day. A therapist can be an important part of healing, but isn’t required. This isn’t to suggest that therapy isn’t helpful, but therapy without “connectedness” is not very effective.

Aboriginal healing practices are repetitive, rhythmic, relevant, relational, respectful, and rewarding—experiences known to be effective in altering neural systems involved in the stress response.

One of the hardest things to grasp about implicit bias and racism is that your beliefs and values do not always drive your behavior. These beliefs and values are stored in the highest, most complex part of your brain—the cortex. But other parts of your brain can make associations—distorted, inaccurate, racist associations. The same person can have very sincere anti-racist beliefs but still have implicit biases that result in racist comments or actions.

white victim make up only 10 percent of all crimes—but they account for 42 percent of what’s reported on television.

Training about trauma, the brain, stress, and distress is essential if you are going to be a first responder—especially a police officer. Anyone given the responsibility of carrying a gun in service of society should have extensive training in these things.

Remember that the cortex is the most malleable, the most changeable part of the brain. Beliefs and values can change.

Implicit bias is much more difficult. You may truly believe that racism is bad, that all people are equal. But those beliefs are in the intellectual part of your brain, and your implicit biases, which are in the lower part of your brain, will still play out every day—in the way you interact with others, the jokes you laugh at, the things you say.

“I’ve never been racist.” “I don’t have a racist bone in my body.” Well, the issue isn’t your bones. It’s your brain. All of us have deeply ingrained biases, and lurking among these are racist associations.

For my Māori hosts, pain, distress, and dysfunction would arise from some form of fragmentation, disconnection, dyssynchrony.

When somebody is being rude, our typical response is to get caught up in the contagion of their emotions—we get dysregulated and then we mirror their rude behaviors. But if you can approach the interaction from a regulated, empathic stance, your response changes.

The unpredictability and insecurities of poverty drain the stress-response system’s bandwidth in ways that make “opportunities” to escape poverty extremely difficult to take advantage of.

This woman was remorseless, expressing no real feeling for the mother she killed or the infant she took. As we talked, she felt empty and cold. She was lacking in empathy. But as we discussed in Chapter 3, you can’t give what you don’t get. If no one ever spoke to you, you can’t speak; if you have never been loved, you can’t be loving.

How ironic that the cultures our modern world has marginalized are the very cultures with the wisdom to heal our modern woes.