What happened to you? Conversations on trauma, resilience, and healing by Bruce Perry, Ph.D and Oprah Winfrey 

This book is absolutely brilliant! 

Our body’s core regulatory systems can be altered by traumatic experiences. 

We come into the world with an innate sense of wholeness. We don’t begin our lives by asking: Am I enough? Am I worthy? Am I deserving or lovable? Oprah talks about how she knew from a young age that she was unwanted. She goes on to describe how she was always trying not to bother or worry her Mother. She knew she was on her own. She discusses feeling a deep longing to feel needed, validated, and valued. 

If we want to understand the oak; its back to the acorn we must go. 

Seemingly senseless behavior makes sense once you look at what is behind it. Something happened that influenced how their brain works. 

Not all of these combat-related memories are in parts of the brain that are within control. The incoming signal is matched against previously stored experiences. Your brain can’t tell time, or know that many years have passed, it activates the stress response and you have a full-blown threat response. When the signal finally gets up to the cortex, the cortex can figure out what’s really going on. 

What was once adaptive has become maladaptive. 

Evocative cues- any sensory input like a sound, sight, smell, taste, or touch. It can activate a traumatic memory. 

As we grow up, we are all trying to make sense of what’s happening around us. We make a personal “codebook” that helps us interpret the world. 

If you were to walk into any home as a stranger, not speaking the language, you could absolutely feel whether this is a place where people are loved. Just as you can sense when something’s off. You may not know what it is, but something feels off. 

When children don’t feel respected by the decisions of their parents, their beliefs about how they are valued are crushed. 

Heart palpitations can be a part of menopause. 

Oprah discusses how she blocks out Sunday’s as a time for renewal, allowing herself to be with herself; allowing herself to simple be. She goes on to say that when that time is interrupted or threatened by someone invading her calm state of mind, she becomes irritable, anxiety prone, and distressed. 

Stress is what occurs when a demand or challenge takes us out of balance. 

There is a correlation between drug addiction and trauma. It is about avoiding the pain and distress of dysregulation. 

Most people with 
developmental adversity” are chronically dysregulated- they tend to be wound up and anxious. They end up with an altered stress-response system. This is especially true is the abuse, chaos, or exposure to violence took place in the home, and the very adults who were supposed to be nurturing and protecting you were the source of the pain, chaos, fear, or abuse. 

It is enough to make your stress-response systems sensitized- overactive and overly reactive- creating the internal storm. The parent’s internal storm then becomes the home’s storm. The persons chaos becomes the home’s chaos. They may use alcohol or a drug to manage the distress. But a drug-using parent, a drunk, overwhelmed, frustrated parent is going to create a climate of fear for their children. The children grow up internalizing this…they are incubated in terror. 

It is very healthy to learn to “fill your reward bucket”. The healthiest way to do this is through relationships. 

When questioned why some medication will work for some and not work the same way for others: Your baseline stress response may already be elevated, and you need more medication to get below the base. So even though people may not appear to be in a state of high alert or anxiety, they are biologically revved up. 

Connectedness counters the pull of addictive behaviors. It is the key. 

Our brains develop as a reflection of the world we grow up with. You love others the way you’ve been loved. 

All of us want to know that what we do, what we say, and who we are matters. 

There is a really interesting story that discusses a boy named Jesse who was in a coma and ‘despite being unconscious, Jesse had a notable physiological response when re-exposed to the scent of these two men [biological father and foster father]. When a piece of clothing from foster father was placed under his nose, he started to thrash and moan, and his heart rate rose from 90bpm to 162. This was a profound arousal response and due to a set of trauma-related memories from his abuse at the hands of his foster father. The evocative cues triggered complex behaviors, emotions, and physiological responses because they are due to memory stored in lower systems in the brain.

Almost 50% of children in the US have had at least one significant traumatic experience. 

How does the individual experience the event? 

A trauma has 3 key aspects- the event, the experience, and the effects. 

There is a simple 10 item questionnaire of “adversities” that may have taken place during the first 18 years of life. The scores range from 0-10. There is a correlation between the ACE score and the 9 major causes of death in adult life. The major finding is that your history of relational health- your connectedness to family, community, and culture- is more predictive of your mental health than your history of adversity. Connectedness has the power to counterbalance adversity. 

The second major finding is the timing of adversity makes a huge difference in determining overall risk. If you experience trauma at age 2, it will have more impact on your health than the same trauma taking place at age 17. 

It is through controllable, brief re-visits that the sensitized system can slowly, painfully be “reset”. 

PTSD is about the effects. The first cluster is “intrusive” symptoms. They are recurring, unwanted images and thoughts of the traumatic event, and dreams or nightmares about it. 

Trauma leaves you shipwrecked. You are left to rebuild your inner world. 

The second cluster is “avoidant” symptoms. These symptoms arise when someone feels distressed after being re-exposed to people, places, or other reminders of the original traumatic events. Avoidant behaviors are an attempt to regain control over what feels like the uncontrollability of the traumatic experience. 

The third cluster is changes in mood and thinking. This can include depressive symptoms. The fourth symptom cluster is an alteration in arousal and reactivity. Symptoms include overactive and overly reactive including anxiety, hypervigilance, increased startle response, high and variable heart rate, and sleep problems. 

We absorb things from previous generations and pass them on to the next generation. Our genes, family, community, society, and culture are all part of this. So your question about fear being inherited is central to understanding trauma, especially “historical trauma”. 

Every family has patterns and pathologies of thought, belief, and behavior that are passed on from one generation to another in the same way that  a physical characteristic is passed on. 

Different patterns of stress can lead to either sensitization or resilience. 

The risk for diabetes and the management of diabetes are related to a history of adversity. 

A person’s “worldview” can change their immune system. 

Children and adults with developmental trauma frequently experience chronic abdominal pain, headaches, chest pain, fainting, and seizure-like episodes- all very common symptoms related to a sensitized stress response. 

Before any new experience has a chance to be considered by the higher, “thinking” part of the brain, the lower brain has already interpreted and responded to it. It’s matched the sensory input from the new experience against the catalog of stored memories of past experiences- before the smart part of your brain even has a chance to get involved. The lower part of the brain can’t “tell time”. 

In order to communicate rationally and successfully with anyone, you have to make sure they’re regulated.

The infant’s version of the fight-or-flight response is to cry. But if crying doesn’t bring the responsive caregiver, or if the crying brings a frustrated or enraged caregiver, the infant is forced to use other self-soothing options. An infant’s dominant adaptive response to stress in these situations is to disengage from the confusing, threatening outside world and retreat into their inner world. 

Relationships are the key to healing. 

What didn’t happen for you? What attention, nurturing touch, reassurance- basically, what love didn’t you get? Neglect is as toxic as trauma. Neglect is most destructive early in life. 

So many important things happen in the developing brain of a child in the first six years of life. 

The longer you spend in a deprived developmental environment, the harder it will be to recover. 

The dissociative response is used when there is inescapable, unavoidable distress and pain. Your mind and body protect you. You psychologically flee to your inner world. 

The opioid “burst” from cutting can actually feel regulating and soothing. People then discover that a reliable way to self-soothe, to east the pain, is to cut yourself. 

Your life is busy, full of challenges and demands, yet you take that set of stressors and you use boundaries and intention to make the pattern of your life’s stress more predictable, controllable, and moderate. That is healing and resilience building pattern of stress activation. 

The most destabilizing thing for anyone is to have their core beliefs challenged. 

Good or bad, we are attracted to things that are familiar. 

You teach people how to treat you.

We can intentionally change if we know what needs to be addressed. The key is to recognize the patterns. 

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 and 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 be punished”. What is happening is that he is seeking a predictable response from the world. Give these children time and experience. 

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. Therapy is building a better alternative, a new default. 

We often use our belief in another person’s “resilience” as an emotional shield.

The capacity to get back to “baseline” after a trauma is influenced by many factors, primarily your connectedness. 

Trauma will change every one in some way. 

If you compare a group of children who’ve experienced no abuse with a group of children who’ve experienced similar timing and type of abuse, there will be statistically significant differences in the size of some areas of the brain. 

Two people who experience the same traumatic event can respond differently- and recover differently. 

Relationships are absolutely key for infants. The relationship with the primary caregivers is the foundation of their capacity for all future relationships. 

It’s very difficult to meaningfully connect with or get through to someone who is not regulated. And it’s nearly impossible to reason with them. This is why telling someone who is dysregulated to “calm down” never works. 

If you control when and how much a traumatized person talks, it can be retraumatizing rather than healing. 

The journey from traumatized to typical to resilient  helps create a unique strength and perspective. That journey can create post traumatic wisdom. 

The medical model overfocuses on psychopharmacology and cognitive behavioral approaches. It greatly undervalues the power of connectedness and rhythm. After going through so much trauma and working through it, you can gain post-traumatic wisdom. 

Even the most seemingly resilient people can be drained by relational poverty and ongoing stress, distress, and trauma.

Most healing happens outside of formal therapy. Most healing happens in community. 

There is a direct relationship between a person’s degree of social isolation and their risk for physical and mental health problems. 

Our behaviors begin to shape themselves around the emotional landmines left by previous trauma. 

When we use the word: SNAPPED- now we know that something has happened in the moment that triggers one of the brain’s trauma memories. 

It is important to understand the prevalence of childhood adversities and the impact of trauma on learning- plus strategies to help create a regulated, safe, and secure classroom. In schools all over the country- we use the Neurosequential Model in Education (NME). All of the successful models have one thing in common: they emphasize regulation and connection. 

There is a newer field, called Traumatology. Bruce Perry (author) also developed the Neurosequential Model of Therapeutics (NMT) and wrote about it in his book, The boy who was raised a dog. 

The therapeutic web is the collection of positive relational-based opportunities you have throughout your day. 

Our first experiences create the filters through which all new experiences must pass. 

“I don’t have a racist bone in my body” is what people will say. Well, the issue isn’t your bones. It’s your brain. We all have deeply ingrained biases. 

Many people have had the experience of feeling “exhausted” after a day of travel, even if all they did was stand in a few lines and sit on a plane. This happens because your brain was continuously monitoring thousands of new stimuli. Remember: activating your stress-response systems, even at a moderate level, for long periods of time is physically and emotionally exhausting. 

Giving toys instead of calming touch is an outrageously misguided practice.

If the adults who live with, teach, and treat these children are not regulated, they will not be able to be fully present in a compassionate, regulated way. 

Relationships are the currency of change. 

Until you heal the wounds of your past, you will continue to bleed. 

 

 

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