Still scared of "shrink-rap"? Relax, Perry's been on Oprah, CNN, in the New York Times and so on. Here's an intro video²:  www.youtube.com/watch?v=jYyEEMlMMb0

I first heard of Bruce Perry in August 2010; not his name, but his substance. I was commuting to another high-pressure defense job on the 91 freeway outside Anaheim, CA, worried about how
to pour concrete at Seal Beach Naval Base. It didn't look to my clients, or to me, as though I had anything wrong with my ultra high-performance business brain.

On the car stereo was yet another CD by Dr. Henry Cloud. "Humans are neurologically designed, physiologically designed, psychologically, spiritually, emotionally, and cognitively designed, to be in a relationship where you are loved,” Cloud announced to my surprise. “You are designed to take aspects of that relationship inside of you, and they actually become a part of who you are. My 17-month-old came into the world with nothing in her head. A lot of need, a lot of hunger, not a lot of words, didn't read much. Babies are all need and they cry. So adults have to calm them, and the minute we put them down, they start crying again.

"But after we do that a million times, the gap for how long they can tolerate not being held gets wider and wider. Because they are taking our love from the outside, and it's becoming part of them on the inside... Love becomes actual equipment that you take in and walk around with on the earth."³ Nice, but I felt kinda sad; I couldn't identify.

But now watch how my body reacts to the right research:

Cloud went on, “We can now do scans of the brain of older kids who were in institutions and were not held, comforted or soothed, and there are parts of the brain which are dark. There's nothing growing in there -- because nothing was planted; neurologically there's literally no brain activity. But the kids who were held and loved, those parts of the brain are physiologically growing.”

I nearly drove off the 91 overpass at 70 MPH. It hit me in the gut the minute he said it. "Oh, S#$%", I thought, "parts of my brain are dark!" (Go tell that to the Marines at Seal Beach.)

It wasn't until March 8 this year, when some guy named Perry stepped to the microphone at UCLA and put up his slides, that I saw the pictures. Here were brain scans of two children aged 3, a normal brain in standard grey, and a brain labeled "extreme neglect," significant parts of which were black and empty. In that moment, I knew Cloud had referred to Bruce Perry's work.⁴

As I've documented in previous posts, maybe 50% of Americans have some degree of attachment disorder, some areas which didn't get that "love on the inside", as Dr. Cloud says. And we don't want to walk around with parts of our brain dark any longer than necessary.

Dr. Perry himself is incredibly modest, always repeating that science is just barely beginning to understand the vast complexity that is the human being, and no method is “it.” But this is my blog, and it's my job to tell you how I feel, so here goes.

of conception, to its later development in infancy and then childhood. He calls this the Neuro-sequential Model of Therapeutics (NMT). Dr. P's "Four Part Brain" slide shows the time sequence from the bottom up: first the brain stem develops (pink); then the diencephalon cerebellum (yellow); then the limbic emotional brain (green), and finally the thinking cortex (blue). 

Who cares about the time sequence? Well, our entire big Einstein brain is an outgrowth of its most primitive part: the brain stem (the knob at the top of the spinal chord), and its spin-off, the cerebellum.

This “reptilian brain” is in the back of your head at the level of the ears. It maintains rock bottom survival such as body temperature, heart rate, sleep, and breathing – all those functions you never think about which if they didn't happen you'd be dead. Not only reptiles have the same apparatus but so do pre-bony fish like sharks. That's humbling: our whole brain starts with something that primitive. 

Who cares, you again ask? Because “Reptile gets first crack at the incoming data,” as Dr. Kevin McCauley puts it.⁵ 

“The first 'stops' for input from the outside environment, e.g., light, sound, and taste, and from inside the body, e.g., temperature, are the 'lower' regulatory areas of the brain--the brain stem and diencephalon, which are incapable of conscious perception,” Dr. Perry said in his UCLA papers March 8. “During development, the brain organizes from bottom to top, with the lower parts of the brain developing earliest.” Reptile brain better hit the ground running from birth or infants don't breathe; the rest of the brain can and does grow in later. “The majority of brain organization takes place in the first four years of life,” Perry says. “Because this is the time when the brain makes the majority of its "primary" associations and the core neural networks organize as a reflection of early experience, early developmental trauma and neglect have disproportionate influence on brain organization and later brain functioning.”⁴

So what goes wrong from “zero to 36 months” can fry our reptilian brain and put it into permanent fight-flight or freeze (dissociation shutdown). And because our reptile brain develops first, and the whole rest of the brain is just an outgrowth of it, the entire brain can then be thrown out of whack starting from its first cell divisions. As the ACE Study has shown, this results in heart, gut, and many other chronic physical diseases throughout adult life. 

“The brain is an historical organ,” Perry's UCLA notes conclude. “The NMT Core Assessment's first step is a review of the key insults, stressors, and challenges during development. Intrauterine insults such as alcohol or perinatal care disruptions (such as an impaired inattentive primary caregiver) alter the norepinephrine, serotonin, and dopamine systems of the brainstem and diencephalon that are rapidly organizing. These early life disruptions result in a cascade of functional problems in brain areas these neural systems innervate.” 

Think your thinking brain's in charge? “Think” again, folks – we've got a wildly arrogant view about how much our thinking cortical brain can do. Fact is, it's the new kid on the block in the brain, and it doesn't have a lot of influence on all those roiling instincts and feelings going on in the subconscious “downstairs” brain and associated neurons and body parts like the heart and the gut, as Dan Siegel dubs this network. Things that may have gone wildly wrong from Square One. 

“When a child has experienced chronic threats, the brain exists in a persisting state of fear,” Perry says. This “makes the stress response oversensitive, overreactive, and dysfunctional due to overutilization of brainstem-driven reactions. Such reactions become entrenched over time, and the 'lower' parts of the brain house maladaptive, influential, and terrifying pre-conscious memories that function as a template for the child's feelings, thoughts, and actions.”⁴

“Cognitive behavioral therapy (CBT) is great if you have a developed frontal cortex - but we're talking about a five year old kid who's so scared to death most of the time that it's shut down his frontal cortex 'cause he just saw his mother get shot,” Perry told his UCLA therapist audience March 8. “You're going to do 20 sessions of CBT and expect change? B#$$%&! (expletive) That's a fantasy.” (Wild applause). 

Listening to him talk, I can feel things inside me resonating, probably things that didn't develop right in the womb, and I can feel these things healing because, finally, here is some compassion for my situation. It's been a remarkable experience. 

This man makes me feel understood, accepted, and wanted in the world. When I hear him and his colleagues clarifying these issues – finally! - it hits me right in the solar plexus and the gut. I feel like someone out there is finally telling me “You're not crazy, this actually happened deep inside you, you don't have to cover up the pain anymore – because you can be understood, you can be accepted, exactly as who you are. 

You can say exactly how you feel for the first time in your life and we are not going to run screaming from the room. We are going to accept you and appreciate you exactly as you are, because we can say scientifically that you are exactly the way you should be, because this is the way your cells developed in the environment you were in.”

Once I begin to feel accepted in this profound way, I literally feel the problem begin to heal. It's been proven by brain scans that this feeling of acceptance and belonging does produce the re-growth of the damaged tissues inside us – precisely because it simulates the missed environment of love and acceptance and “we're glad you're here” which the infant was designed to experience in the first place. 

Growing up, it didn't occur to me that I should not exist. What I did often mutter to myself starting at age 8 or so, was: “This wasn't my idea, to be here! Why did you have a child, if you didn't want children?” This was directed at my parents, who clearly were not happy with me. Validation is powerful, especially this late in life.

Perry and friends are validating the fact that I should exist, I should exist in exactly the shape I'm in without having to constantly apologize that I'm a mess, and that in fact I'm wanted to exist. After feeling “un-wanted to exist” for a lifetime, that, my friends is a very big deal. 

“Born for Love” 

Perry and his colleagues like Bessel Van der Kolk, Daniel Siegel, Allan Schore, and Mary Jo Barrett, are also overturning the American Psychiatric Association (APA) apple cart with their break-through in naming this “developmental” trauma. It starts in the womb and goes on from there continually in the pre-conscious years. They point out that it differs completely from incident-by-incident based trauma such as assault, rape, school violence, or combat stress, which can hit at any age. These later “PTSD” traumas have been assumed to be “all” of trauma, but horrible as they are, they are just not all there is.
 

Dr. Cloud's talk of “getting love on the inside.”

“Attachment is when the baby learns by thousands of good experiences that stress is tolerable because it leads to reward opiates such as dopamine in our body, and that this pleasurable outcome is cathexsized to a person, Mom, who consistently attunes to it about this,” Perry said March 8 at UCLA. “When the baby feels distress, the attuned Mom feels distress and gets her own pleasure rewards by responding to the baby. So the infant brain weaves together the neurobiology of what interaction with another human being is, and connects it to stress relief, pleasure and safety, when this happens repeatedly. Ultimately, just seeing or hearing Mom makes you feel safe and pleasurable. Let a wounded combat soldier talk to his mom, and he'll require 45% less pain meds."  

Dr. Perry goes into a lot of neurobiology detail with his slide above showing an attentive mother creating attunement and attachment with her baby and you can hear it in his Sept. 5 talk. So what do we do now if we missed the boat as a kid?

Hope and Healing

“Because the brain is organized in a hierarchical fashion, with symptoms of fear first arising in the brain stem and then moving all the way to the cortex, the first step in therapeutic success is brain stem regulation,” Perry said at UCLA. “An example of a repetitive intervention is positive, nurturing interactions with trustworthy peers, teachers, and caregivers, especially for neglected children who have not had the neural stimulation to develop the capacity to bond with others.

“Others are dance, music, or massage, especially for children whose persisting fear state is so overwhelming that they cannot improve via increased positive relationships, or even therapeutic relationships, until their brain stem is regulated by safe, predictable, repetitive sensory input.” An hour here and there of even sensitive therapy is rarely enough.

“Children with relational stability and multiple positive, healthy adults invested in their lives improve; children with multiple transitions, chaotic and unpredictable family relations, and relational poverty do not improve even when provided with the best "evidence-based" therapies. The healing environment is a safe, relationally-enriched environment," Dr. Perry continues. 

“The only way you can move from these super-high anxiety states, to calmer more cognitive states, is RHYTHM. Patterned, repetitive rhythmic activity: walk, run, dance, sing, repetitive meditative breathing – you use brain stem-related somato-sensory networks which make your brain accessible to relational reward and cortical thinking.

“If you want a person to use relational reward, or cortical thought – they've got to be emotionally regulated first! We must regulate people, before we can possibly persuade them with a cognitive argument or compel them with an emotional affect. All our contingency-based models do nothing but merely escalate their negative arousal!”

Sound stupid and ineffective, like your doctor saying “Scram and go calm down in the gym”?

 I thought so – until I tried it.

It works, big time. But what happened was so explosive, that's another blog for another day (I don't want to spoil the punchlines later in my book.)

The take-away today is Step 1: Get informed about reality. Listen to Dr. Perry, figure out how your brain actually works, see if anything he says resonates inside. There is enormous healing simply in that – it can make you feel accepted, validated, and yes folks, finally “loved and wanted.”

Then: stay tuned to find out how it played out for me. Or if you can't wait, as I've said before, find a really empathic, loving therapist who knows trauma inside out, and bring him that Peter Levine book. You'll need professional supervision when you do the exercises on the CD in the back of Levine's book, and look out world.⁶

Even if you're 92, you can grow parts of your brain. Daniel Siegel did it with a 92 year old lawyer.⁷ Stay tuned for more.


Excerpts from Kathy's forthcoming book DON'T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder - How I accidentally regressed myself back to infancy and healed it all are posted here most Fridays, unless current events beg an interruption. Watch for the continuing series of excerpts from the rest of her book, in which she explores her journey of recovery and shares the people and tools that have helped her along the way.

Series Table of Contents

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Footnotes

1. Perry, Bruce D. MD, PhD, "Helping Children Recover from Trauma," National Council LIVE, National Council on Behavioral Health, September 5, 2013; Dr. Perry is co-author of "The Boy Who Was Raised As A Dog," and "Born for Love: Why Empathy Is Essential--and Endangered." He presented live to SRO audiences at the 2013 National Council Conference in Las Vegas. He has appeared on Oprah, CNN, and NPR, and has been cited in Newsweek, the New York Times, and The New Yorker on empathy’s startling importance in human evolution and its significance for our children and our society. http://www.thenationalcouncil.org/events-and-training/webinars/
2. Bruce Perry, Daniel Siegel, et.al, “Trauma, Brain & Relationship: Helping Children Heal,” (25 Minutes) www.youtube.com/watch?v=jYyEEMlMMb0 Introductory video on Attachment Disorder. A new understanding of how trauma effects the development of the mind-body system, and how it affects children's behaviors and social relationships. Copies can be purchased a www.postinstitute.com/dvds. Video originally by Santa Barbara Graduate Institute which no longer exists as a separate entity.
3. Cloud, Henry, PhD, “Getting Love on the Inside,” Lecture, April 2002 (CD), Mariner's Church, Newport Beach CA, www.Cloud-Townsend Resources.com, [Coauthor with Townsend, John, PhD, of “Boundaries,” Zondervan, 2004]
4. Perry, Bruce, MD, PhD, “Born for Love: The Effects of Empathy on the Developing Brain,” speech to Annual Interpersonal Neurobiology Conference “How People Change: Relationship & Neuroplasticity in Psychotherapy,” UCLA Extension, Los Angeles, March 8, 2013; Bruce D. Perry and Erin P. Hambrick, “The Neurosequential Model of Therapeutics,” Reclaiming Children and Youth Magazine, Fall 2008 vol 17. nr 3, www.reclaiming.com, (UCLA handout); Perry, Bruce, “Overview of Neuro-sequential Model of Therapeutics (NMT),” article on www.childtrauma.org, 2010
5. McCauley, Kevin T., MD, "The Disease Model of Addiction," CD, (no year given) www.addictiondoctor.com/products.html
6. Levine, Peter A., “Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body,” 'Sounds True, Inc.,' Boulder CO, 2005; ISBN 1-159179-247-9
7. Siegel, Daniel J., MD, “How Mindfulness Can Change the Wiring of Our Brains, National Institute for the Clinical Application of Behavioral Medicine (NICABM), www.nicabm.com,       March 2011. Check for the passage on a 92 year old lawyer code-named “Stewart.”