A long shadow is cast by childhood trauma because of its profound impact on the developing brain, an American psychiatrist says.
Dr Bruce Perry is an expert on the impact of abuse, neglect and trauma on the developing brain and the implications for clinical practice.
For three decades he has been an active teacher, clinician and researcher in children's mental health and the neurosciences, holding a variety of academic positions.
Photo: supplied by Emily Perry/Neurosequential Network
New Zealand paediatrician Dr Robin Fancourt led the way in this field, Dr Perry told Kathryn Ryan..
“Her work and the work of her colleagues including our group, focused many, many years ago on trying to understand how chaos, exposure to threat, domestic violence and other forms of abuse and neglect impacted the developing child.”
This work showed that traumatic early experiences literally change the biology of the brain, he says.
“If you have a seriously distressing experience as an infant, and you are terrorised, or you feel as if you are in harm's way for prolonged time, your brain will literally turn on certain genes, it'll turn off other genes, certain neural networks will develop in a way that make them overactive and overly reactive even into childhood and in some cases into adult life.
"And the echo, that the long shadow, I kind of think of it as an echo because it's a little bit like dropping a pebble in a pond. The event may have taken place many, many years ago. But those echoes and the ripple effects can carry through into adult life.”
The architecture of the brain is behind this, he says
“Envision the brain as an upside-down triangle. And the lower part, the bottom, people refer to it as the lizard brain, it's the most simple, regulatory part of the brain, it does a lot of great things but it's not the part of your brain that's involved in thinking, it's really involved in reacting.
“The middle part of the brain is involved in interpreting information and giving it emotional value.
“Once you get to the very top part of your brain, the cortex, that's the part of the brain where you do your thinking, these uniquely human attributes of reflecting on something in the past or anticipating the future and making a plan.”
However, the part of the brain that does the immediate processing is the lizard brain, he says.
“So, when you interact with somebody, the immediate response that your brain will have is going to be to non-verbal signals.”
Such things as tone of voice, how close the person is standing, whether or not that person has attributes that are similar to people we know and trust, he says.
That information is then passed through the next ladders of the brain, the emotional and then to the rational cortex, Dr Perry says.
“The irony is during development the last part of your brain to organise and develop and function properly is your cortex, that top part of your brain.
“And that doesn't really fully develop until you're probably in your mid-20s to late-20s.
“So, the developing child doesn't have full access to that smartest part of the brain and by the time information gets to the smart part of your brain a lot of times it's been short circuited by misunderstanding or mislabelling.”
That leads to conflict and distortion, he says.
“People who will hear the exact same thing but their brains will turn it into completely different arguments… and they'll walk away with a different understanding of what was just said and it's in part because of that sequential processing that starts with the lizard brain, which is the least rational part of us.”
The lowest part of the brain has neurotransmitter networks that go from the brain, to every other part of the body, he says.
“They either go directly through neuronal connection, or they go indirectly through hormonal connection.
“These systems, which are getting nonstop input from the outside world, and the inside world, kind of telling you what's going on, these systems play this uniquely important role in orchestrating and integrating function across your whole body.”
When there is a prolonged pattern of stress activation or chaotic and unpredictable behaviour those systems start to become overactive and overly reactive, he says.
“That abnormality in activity starts to influence the development of higher parts of the brain, but it also starts to influence the way your heart works, and the way your pancreas works and the way your lungs work.
“And so over time, you have the probability of becoming increasingly vulnerable to physical disease, as well as social problems and mental health problems and learning problems.”
Therefore, early development experiences determine the regulatory status of important neurotransmitter networks, and play a disproportionate role in shaping how we develop and how we function in later life, Dr Perry says.
Much of his work in the last three decades has been to determine what to do about the implications of early childhood trauma, he says.
“The first part of the brain that starts to shut down under threat is the cortex. And one of the fundamental things that we learned very quickly, was that if you try to teach a child who has an overactive stress response system, you can have the best curriculum and the best teacher on the planet, but it still won't get up to their cortex, it'll get short circuited by this active stress response.
So, we teach educators and students that before you try to use your cortex, before you try to reason with somebody, you need to be regulated.”
Regulated means quieting the stress system and can be achieved through deep breathing or other physical exercises, he says.
“We will typically recommend that classes will start with two or three minutes of regulatory activity.
“Some places will use deep breathing, some places use music, some people use a large motor activity like jumping jacks.”
Repetitive pattern rhythms are also an effective quietening strategy, he says.
“Traditionally for generations and generations and generations our indigenous communities have used pattern repetitive rhythmic activities as part of their educational practices, part of their problem solving process, part of their healing process.
“And it really reflects a certain wisdom and recognition that people can't think clearly and make good decisions unless they’re regulated.
“So, before we make a big decision for the clan, let's regulate. Let's make sure everybody's fed. Let's make everybody sure everybody feels safe. Let's have a dance. Let's sing a song. Let's get everybody in the same space. Let's make everybody feel safe and connected. And then we'll make a decision.”
We are able to recover from maladjusted responses, he says, the change is normally incremental and needs strong relational bonds.
“We've found that most positive therapeutic change happens in incremental moments that are provided by the people in our life.
“And if you are lucky enough to have connection to community and culture, and family, that those interactions, the opportunities of a relationally wealthy life often provide the necessary elements for therapeutic healing.”
The modern world makes this healing difficult, he says.
“Because far too many of us live in relational poverty.
“We've moved away from our extended family, we're not connected to a community of faith, we're disconnected from our culture, we spend too much time in front of a screen, we have a small group of friends.
“And so the relational opportunities that are required to both identify our patterns that are maladaptive and to change them are frequently not there.”
Recreating healthy community has been an important part of his recent work, he says.
“To create connection in communities and let that natural healing component, the natural educational component of connectedness take place.
“And I think if we did that many of our issues around education and mental health and child welfare would be would be solved - not 100 percent, but significantly assisted."
Dr Bruce Perry is the principal of the Neurosequential Network, senior fellow of The Child Trauma Academy. He is a bestselling author and the co-author of The Boy Who Was Raised As A Dog.
