Bruce Perry Quotes

The truth is, you cannot love yourself unless you have been loved and are loved. The capacity to love cannot be built in isolation.

For years mental health professionals taught people that they could be psychologically healthy without social support, that “unless you love yourself, no one else will love you.”…The truth is, you cannot love yourself unless you have been loved and are loved. The capacity to love cannot be built in isolation

The more healthy relationships a child has, the more likely he will be to recover from trauma and thrive. Relationships are the agents of change and the most powerful therapy is human love.

We elicit from the world what we project into the world; but what you project is based upon what happened to you as a child.

Fire can warm or consume, water can quench or drown, wind can caress or cut. And so it is with human relationshps; we can both create and destroy, nurture and terrorize, traumatize and heal each other

Fire can warm or consume, water can quench or drown, wind can caress or cut. And so it is with human relationships: we can both create and destroy, nurture and terrorize, traumatize and heal each other.

Relationships matter: the currency for systemic change was trust, and trust comes through forming healthy working relationships. People, not programs, change people.

The saddest aspect of life right now is that science gathers knowledge faster than society gathers wisdom.

Because what I know for sure is that everything that has happened to you was also happening for you. And all that time, in all of those moments, you were building strength. Strength times strength times strength equals power. What happened to you can be your power. — Oprah

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.

To develop a self one must exercise choice and learn from the consequences of those choices; if the only thing you are taught is to comply, you have little way of knowing what you like and want.

What I’ve learned from talking to so many victims of traumatic events, abuse, or neglect is that after absorbing these painful experiences, the child begins to ache. A deep longing to feel needed, validated, and valued begins to take hold. As these children grow, they lack the ability to set a standard for what they deserve. And if that lack is not addressed, what often follows is a complicated, frustrating pattern of self-sabotage, violence, promiscuity, or addiction.

They prefer the certainty of misery to the misery of uncertainty

Our 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 (see Figure 8). This is similar to the findings of other researchers looking at the power of positive relationships on health. Connectedness has the power to counterbalance adversity.

Biology isn’t just genes playing out some unalterable script. It is sensitive to the world around it,

Surprisingly, it is often when wandering through the emotional carnage left by the worst of humankind that we find the best of humanity as well.

the most powerful form of reward is relational. Positive interactions with people are rewarding and regulating. Without connection to people who care for you, spend time with you, and support you, it is almost impossible to step away from any form of unhealthy reward and regulation.

Relationships are the agents of change and the most powerful therapy is human love

It’s interesting-most people think about therapy as something that involves going in and undoing what’s happened. But whatever your past experiences created in your brain, the associations exist and you can’t just delete them. You can’t get rid of the past. 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. And that takes repetition, and time, honestly, it works best if someone understands how the brain changes. This is why understanding how trauma impacts our health is essential for everyone.

Empathy underlies virtually everything that makes society work—like trust, altruism, collaboration, love, charity. Failure to empathize is a key part of most social problems—crime, violence, war, racism, child abuse, and inequity, to name just a few.

We ignore the emotional needs of young children at our peril.

What happened to you as an infant has a profound impact on this capacity to love and be loved.

We make memories, but memories make us, too…

Negative emotions often make things even more memorable than positive ones because recalling things that are threatening—and avoiding those situations in the future if possible—is often critical to survival.

...the speed with which we're inventing our world is outpacing our avility to understand the impact of our inventions.

stress is not something to be afraid of or avoided. It is the controllability, pattern, and intensity of stress that can cause problems.

Dr. Perry: That’s a wonderful example of the glue of love. It is in the small moments, when we feel the other person fully present, fully engaged, connected, and accepting, that we make the most powerful, enduring bonds.

Think about how you’ve handled difficulty in your own life. With things that are very hard to deal with, you don’t want to talk about the pain or loss or fear for forty-five minutes nonstop. You want to talk with a really good friend for maybe two or three minutes about some aspect of it. When it gets too painful, you step back, you want to be distracted. And maybe you want to talk more later on. It is the therapeutic dosing that leads to real healing. Moments. Fully present, powerful, and brief.

we all require some reciprocal social feedback to stay engaged.

Your connectedness to other people is so key to buffering any current stressor—and to healing from past trauma. Being with people who are present, supportive, and nurturing. Belonging.

Now, as I’ve suggested before, what is adaptive for children living in chaotic, violent, trauma-permeated environments becomes maladaptive in other environments-especially school. The hypervigilance of the Alert state is mistaken for ADHD; the resistance and defiance of Alarm and Fear get labeled as oppositional defiant disorder; flight behavior gets them suspended from school; fight behavior gets them charged with assault. The pervasive misunderstanding of trauma-related behavior has a profound effect on our educational, mental health, and juvenile justice systems.

Surprisingly, it is often when wandering through the emotional carnage left by the worst of humankind that we find the best of humanity ad well.

The most traumatic aspects of all disasters involve the shattering of human connections. And this is especially true for children. Being harmed by the people who are supposed to love you, being abandoned by them, being robbed of the one-on-one relationships that allow you to feel safe and valued and to become humane—these are profoundly destructive experiences. Because humans are inescapably social beings, the worst catastrophes that can befall us inevitably involve relational loss. As a result, recovery from trauma and neglect is also all about relationships—rebuilding trust, regaining confidence, returning to a sense of security and reconnecting to love. Of course, medications can help relieve symptoms and talking to a therapist can be incredibly useful. But healing and recovery are impossible—even with the best medications and therapy in the world—without lasting, caring connections to others.

memory is what the brain does, how it composes us and allows our past to help determine our future. In no small part memory makes us who we are

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.

Like people who learn a foreign language later in life, Virginia and Laura will never speak the language of love without an accent.

belonging and being loved are core to the human experience. We are a social species; we are meant to be in community—emotionally, socially, and physically interconnected with others.

AFTER ALL, ONE OF THE DEFINING elements of a traumatic experience—particularly one that is so traumatic that one dissociates because there is no other way to escape from it—is a complete loss of control and a sense of utter powerlessness. As a result, regaining control is an important aspect of coping with traumatic stress.

Reducing economic inequality and helping victims of domestic violence and child abuse are critical if we want to cut violence and crime.

Trauma leaves your shipwrecked. You are left to rebuild your inner world. Part of the rebuilding, the healing process, is revisiting the shattered hull of your old worldview; you sift through the wreckage looking for what remains, seeking your broken pieces…as you revisit the ship-wreck, piece by piece, you find a fragment and move it to your new, safer place in the now-altered landscape. You build a new worldview. That takes time. And many visits to the wreckage. And this process involves both unconscious and conscious repetitive “reenactment” behaviors, or writing, drawing, sculpting, or playing. Again and again, you revisit the site of the earthquake, look through the wreckage, take something, and move it to a safe haven. That’s part of the healing process.

So often we use the word snapped when we don’t know where a burst of anger is coming from or why someone is having a violent reaction. Well, now we know: Something has happened in the moment that triggers one of the brain’s trauma memories. And because the lower, non-rational parts of the brain are its first responders, they immediately set off stress responses that then shut off the reasonable part of the brain. And so that “burst” of violence is actually the result of some highly organized processes in the brain. And in this case, the first thing the school is going to say is, What’s wrong with him?

The responses of traumatized children are often misinterpreted...Because new situations are inherently stressful, and because youth who have been through trauma often come from homes in which chaos and unpredictability appear "normal" to them, they may respond with fear to what is actually a calm and safe situation. Attempting to take control of what they believe is the inevitable return of chaos, they appear to " provoke" it in order to make things feel more comfortable and predictable. Thus, the "honeymoon" period in foster care will end as the child behaves defiantly and destructively in order to prompt familiar screaming and harsh discipline. Like everyone else, they feel more comfortable with what is "familiar". As one family therapist famously put it, we tend to prefer the "certainty of misery to the misery of uncertainty".

The elders were very patient with my curiosity, and gently amused at my Western medical-model formulations of “disease” when I asked how they handled depression, sleep problems, drug abuse, and trauma. They kept trying to help me understand that these problems were all basically the “same thing.” The problems were all interconnected. In Western psychiatry we like to separate them, but that misses the true essence of the problem. We are chasing symptoms, not healing people.

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

My friend, the poet Mark Nepo, says that the pain was necessary in order to know the truth. But we don’t have to keep the pain alive in order to keep the truth alive.

In fact, some theories of language development suggest that humans learned to dance and sing before we could talk, that music was actually the first human language.

Connectedness regulates and rewards us.

You can’t give what you don’t have.

the more threatened or stressed we are, the less access we have to the smart part of our brain, the cortex

the capacity to be connected in meaningful and healthy ways is shaped by our earliest relationships. Love, and loving caregiving, is the foundation of our development

The capacity to love cannot be built in isolation. I

A society that fails to value communality — our need to belong, to care for one another, and to feel caring energy flowing toward us — is a society facing away from the essence of what it means to be human. Pathology cannot but ensue. To say so is not a moral assertion but an objective assessment. "When people start to lose a sense of meaning and get disconnected, that's where disease comes from, that's where breakdown in our health — mental, physical, social health — occurs," the psychiatrist and neuroscientist Bruce Perry told me. If a gene or virus were found that caused the same impacts on the population's well-being as disconnection does, news of it would bellow from front-page headlines. Because it transpires on so many levels and so pervasively, we almost take it for granted; it is the water we swim in. We are steeped in the normalized myth that we are, each of us, mere individuals striving to attain private goals. The more we define ourselves that way, the more estranged we become from vital aspects of who we are and what we need to be healthy. Among psychologists there is a wide-ranging consensus about what our core needs consist of. These have been variously listed as: - belonging, relatedness, or connectedness; - autonomy: a sense of control in one's life; - mastery or competence; - genuine self-esteem, not dependent on achievement, attainment, acquisition, or valuation by others; - trust: a sense of having the personal and social resources needed to sustain one through life; - purpose, meaning, transcendence: knowing oneself as part of something larger than isolated, self-centered concerns, whether that something is overtly spiritual or simply universal/humanistic, or, given our evolutionary origins, Nature. "The statement that the physical and mental life of man, and nature, are interdependent means simply that nature is interdependent with itself, for man is a part of nature." So wrote a twenty-six-year-old Karl Marx in 1844. None of this tells you anything you don't already know or intuit. You can check your own experience: What's it like when each of the above needs is met? What happens in your mind and body when it's lacking, denied, or withdrawn?

As you learn anything, in fact, your brain is constantly checking current experience against stored templates—essentially memory—of previous, similar situations and sensations, asking “Is this new?” and “Is this something I need to attend to?

We also need to recognize that not all stress is bad, that children require challenges and risk as well as safety. It is natural to want to protect our children, but we need to ask ourselves when the desire for risk-free childhoods has gone too far. The safest playground, after all, would have no swings, no steep slides, no rough surfaces, no trees, no other children—and no fun. Children’s brains are shaped by what they do slowly and repeatedly over time. If they don’t have the chance to practice coping with small risks and dealing with the consequences of those choices, they won’t be well prepared for making larger and far more consequential decisions.

The core lessons these children have taught me are relevant for us all. Because in order to understand trauma we need to understand memory. In order to appreciate how children heal we need to understand how they learn to love, how they cope with challenge, how stress affects them. And by recognizing the destructive impact that violence and threat can have on the capacity to love and work, we can come to better understand ourselves and to nurture the people in our lives, especially the children.

unbeknownst

You love others the way you’ve been loved.

Drugs and alcohol are not my problem,” he wrote. “Reality is my problem, drugs and alcohol are my solution.

Relationships are the agents of change and the most powerful therapy is human love.

Humans are social animals, highly susceptible to emotional contagion. Training, logic, and intelligence are often no match for the power of groupthink.

Balance is the core of health. We feel and function best when our body’s systems are in balance, and when we’re in balance with friends, family, community, and nature.

Through moderate, predictable challenges our stress response systems are activated moderately. This makes for a resilient, flexible stress response capacity. The stronger stress response system in the present is the one that has had moderate, patterned stress in the past.

We tend to use the word stress in negative ways, but stress is merely a demand on one or more of our body’s many physiological systems. Hunger, thirst, cold, working out, a promotion at work: All are stressors, and stress is an essential and positive part of normal development; it’s a key element in learning, mastering new skills, and building resilience. The key factor in determining whether stress is positive or destructive is the pattern of stress,

Human beings fear what they don’t understand. The unknown scares us. When we meet people who look or act in unfamiliar or strange ways, our initial response is to keep them at arm’s length. At times we make ourselves feel superior, smarter or more competent by dehumanizing or degrading those who are different. The roots of so many of our species’s ugliest behaviors—racism, ageism, misogyny, anti-Semitism, to name just a few—are in this basic brain-mediated response to perceived threat. We tend to fear what we do not understand, and fear can so easily twist into hate or even violence because it can suppress the rational parts of our brain.

By understanding and increasing just this one capacity of the human brain, an enormous amount of social change can be fostered. Failure to understand and cultivate empathy, however, could lead to a society in which no one would want to live—a cold, violent, chaotic, and terrifying war of all against all. This destructive type of culture has appeared repeatedly in various times and places in human history and still reigns in some parts of the world. And it’s a culture that we could be inadvertently developing throughout America if we do not address current trends in child rearing, education, economic inequality, and our core values.

I believe we don’t have enough quiet conversational moments listening to a friend with no other distractions. That kind of interaction leads to a completely different quality of human connection. A different depth.

In fact, the research on the most effective treatments to help child trauma victims might be accurately summed up this way: what works best is anything that increases the quality and number of relationships in the child’s life.

Even in the absence of major traumatic events, unpredictable stress and the lack of control that goes with it are enough to make our stress-response systems sensitized - overactive and overly reactive- creating the internal storm.

The risks for heart disease, stroke, depression, diabetes, asthma, and even many cancers are all affected by trauma-related changes in the stress response system. Empathy and connection affect physical—not just mental—wellness and health.

When we get back into balance, we feel better. Relief of distress—getting back into balance—activates the reward networks in the brain. We feel pleasure when we get back into balance—from cold to warm, thirsty to quenched, hungry to satiated.

Unfortunately, that basic sense of fairness and goodwill toward others is under threat in a society like ours that increasingly enriches the richest and abandons the rest to the vagaries of global competition. More and more our media and our school systems emphasize material success and the importance of triumphing over others both athletically and in the classroom. More and more, in an atmosphere of increased competitiveness, middle- and upper-class parents seem driven to greater and greater extremes to give their offspring whatever perceived “edge” they can find. This constant emphasis on competition drowns out the lessons of cooperation, empathy and altruism that are critical for human mental health and social cohesion.

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.

When the attentive and responsive adult comes to the crying infant, two very important things happen. The baby feels the pleasure of being regulated after being distressed—and also experiences the sight, smell, touch, sound, and movement of human interaction.

Our conscious memory is full of gaps, of course, which is actually a good thing. Our brains filter out the ordinary and expected, which is utterly necessary to allow us to function. When you drive, for example, you rely automatically on your previous experiences with cars and roads; if you had to focus on every aspect of what your senses are taking in, you’d be overwhelmed and would probably crash.

When a baby gets hungry and cries his levels of stress hormones will move upward. But if Mom or Dad regularly comes to feed him, they go back down, and over time, they become patterned and repetitive thanks to the daily routine. At times, nonetheless, the baby will feel distress and cry: not hungry, not wet, not in discernible physical pain, she will appear inconsolable. When this happens most parents hug and rock their children, almost instinctively using rhythmic motion and affectionate touch to calm the child. Interestingly, the rate at which people rock their babies is about eighty beats per minute, the same as a normal resting adult heart rate. Faster and the baby will find the motion stimulating; slower and the child will tend to keep crying. To soothe our children we reattune them physically to the beat of the master timekeeper of life.

What could prompt parents to give up sleep, sex, friends, personal time and virtually every other pleasure in life to meet the demands of a small, often irritatingly noisy, incontinent, needy being? The secret is that caring for children is, in many ways, indescribably pleasurable. Our brains reward us for interacting with our children, especially infants: their scent, the cooing sounds they make when they are calm, their smooth skin and especially, their faces are designed to fill us with joy. What we call “cuteness” is actually an evolutionary adaptation that helps ensure that parents will care for their children, that babies will get their needs met, and parents will take on this seemingly thankless task with pleasure.

When you drive, for example, you rely automatically on your previous experiences with cars and roads; if you had to focus on every aspect of what your senses are taking in, you’d be overwhelmed and would probably crash. As you learn anything, in fact, your brain is constantly checking current experience against stored templates—essentially memory—of previous, similar situations and sensations, asking “Is this new?” and “Is this something I need to attend to?

We need to allow children to try and fail. And when they do make the stupid, shortsighted decisions that come from inexperience, we need to let them suffer the results. At the same time we also need to provide balance by not setting policies that will magnify one mistake, like drug use or fighting, into a life-derailing catastrophe. Unfortunately, this is exactly what our current "zero tolerance" policies- —that expel children from school for just one rule violation—do.

In the wake of trauma, the hardest thing to understand is that nothing and no one can take away the pain. And yet that’s exactly what we desperately want to do-because we are social creatures, subject to emotional contagion, and when we’re around people who are hurting, we hurt too. We don’t want to hurt. It is hard to sit in the midst of ruined lives and not feel the misery. It helps us regulate to try to undo or negate-to look away from others’ pain. So we make our arbitrary assumptions about people’s innate resilience. We make our sweeping declarations that allow us to marginalize traumatized children. We take our focus off the tragedy, move on with our lives, telling ourselves that “they” will be okay. But as we continue to see in our discussions, the impact of trauma doesn’t simply fade away. We can help each other heal, but often assumptions about resilience and grit blind us to the healing that leads us down the painful path to wisdom.

Social networking sites can link us to distant relatives and friends with whom we might otherwise lose touch. These contacts and the emotions they engage are real. And when online social networks or games add to face-to-face relationships—rather than substitute for them—they can improve our relatedness and compassion.

Recognizing the power of relationships and relational cues is essential to effective therapeutic work and, indeed, to effective parenting, caregiving, teaching and just about any other human endeavor. This would turn out to be a major challenge as we started working with the Davidian children. Because, as I soon discovered, the CPS workers, law enforcement officers and mental health workers involved in trying to help the children were all overwhelmed, stressed out and in a state of alarm themselves.

Although I do not mean to imply that all of these children will be severely “damaged” by these experiences, the most moderate estimates suggest that at any given time, more than eight million American children suffer from serious, diagnosable, trauma-related psychiatric problems. Millions more experience less serious but still distressing consequences.

Working with traumatized and maltreated children has also made me think carefully about the nature of humankind and the difference between humankind and humanity. Not all humans are humane. A human being has to learn how to become humane. That process—and how it can sometimes go terribly wrong—is another aspect of what this book is about. The stories here explore the conditions necessary for the development of empathy—and those that are likely, instead, to produce cruelty and indifference. They reveal how children’s brains grow and are molded by the people around them. They also expose how ignorance, poverty, violence, sexual abuse, chaos and neglect can wreak havoc upon growing brains and nascent personalities.

Why do money and possessions so rarely bring the happiness we expect? Because they often distance us from one another, rather than bringing us closer, emphasizing status gaps, not narrowing them. And, finally, what causes much of life’s most agonizing pain? This, too, is related to relationships—those we lose, fail to maintain, or that become one-sided or abusive.

We have talked a lot about how the actions of caregivers influence the child, but it’s important to remember that those caregivers were also children influenced by their caregivers. The effects of trauma stretch far and wide across generations and across communities, and it’s important to always come back to our central question with compassion: What happened to you?

The language we speak, the beliefs we hold-both good and bad-are passed from generation to generation through experience. And so many aspects of the human experience are invented-as opposed to simply springing up from our genes. Ten thousand years ago, humankind had the genetic potential to read a book, yet not one single human on the planet could read; the genetic potential to play the piano existed, yet not one person could play; the genetic potential to dunk a basketball, type a sentence, ride a bicycle-all that potential existed, but it all remained unexpressed. Humankind, more than any other species, can take the accumulated, distilled experiences of previous generations and pass these inventions, beliefs, and skills to the next generation. This is sociocultural evolution. We learn from our elders, and we invent, and we pass what we’ve learned and invented to the next generations. And the organ that allows this is the human brain-specifically, the cortex. As we’ve said before, the cortex is the most uniquely human part of our body, and, no surprise, it gives rise to the most uniquely human capabilities: speech, language, abstract thinking, reflecting on the past, planning for the future. Our hopes, dreams, and a major part of our worldview are mediated by our cortex.

But throughout history, while some humans have been our best friends and kept us safe, others have been our worst enemies. The major predators of human beings are other human beings. Our stress-response systems, therefore, are closely interconnected with the systems that read and respond to human social cues. As a result we are very sensitive to expressions, gestures and the moods of others. As we shall see, we interpret threat and learn to handle stress by watching how those around us. We even have special cells in our brains that fire, not when we move or express emotions, but when we see others do so.

And for me, the really fascinating part is the power of brief but positive caregiving interactions. Some of the children we studied had attentive and responsive care for only the first two months of life-and then their world imploded. Years of chaos, threat, instability, and trauma followed those positive two first months-yet they did much better than children who experienced initial trauma and neglect followed by years of attentive, supportive care. It is the timing that is so important. The value of early intervention programs, even those that have only brief ‘doses’ of positive interaction, can’t be underestimated.

Because in order to understand trauma we need to understand memory. In order to appreciate how children heal we need to understand how they learn to love, how they cope with challenge, how stress affects them. And by recognizing the destructive impact that violence and threat can have on the capacity to love and work, we can come to better understand ourselves and to nurture the people in our lives, especially the children.

Even in utero and after birth, for every moment of every day, our brain is processing the nonstop set of incoming signals from our senses. Sight, sound, touch, smell, taste—all of the raw sensory data that will result in these sensations enter the lower parts of the brain and begin a multistage process of being categorized, compared to previously stored patterns, and ultimately, if necessary, acted upon. In many cases the pattern of incoming signals is so repetitive, so familiar, so safe and the memory template that this pattern matches is so deeply engrained, that your brain essentially ignores them. This is a form of tolerance called habituation.

If you get into a relationship with somebody who’s not treating you poorly, you may find yourself feeling increasingly uncomfortable. And then, unconsciously, your mind might seek a ‘predictable’ response. You may try to provoke a bit of a response. Maybe I’ll do X and it’ll piss him off. If this elicits the behavior you’re most familiar with-he gets angry and treats you poorly-it can actually be validating. The worldview has been confirmed. Even though the result is chaos and conflict, it’s comforting to know that it’s familiar.

Of course, the diagnosis of PTSD was only itself introduced into psychiatry in 1980. At first, it was seen as something rare, a condition that only affected a minority of soldiers who had been devastated by combat experiences. But soon the same kinds of symptoms—intrusive thoughts about the traumatic event, flashbacks, disrupted sleep, a sense of unreality, a heightened startle response, extreme anxiety—began to be described in rape survivors, victims of natural disaster and people who’d had or witnessed life-threatening accidents or injuries. Now the condition is believed to affect at least 7 percent of all Americans and most people are familiar with the idea that trauma can have profound and lasting effects. From the horrors of the 9/11 terrorist attacks to the aftermath of Hurricane Katrina, we recognize that catastrophic events can leave indelible marks on the mind.

Growth of the Body and the Brain. The physical growth of the human body increases in a roughly linear manner from birth through adolescence. In contrast, the brain’s physical growth follows a different pattern. The most rapid rate of growth takes place in utero, and from birth to age four the brain grows explosively. The brain of the four-year-old is 90 percent adult size! A majority of the physical growth of the brain’s key neural networks takes place during this time. It is a time of great malleability and vulnerability as experiences are actively shaping the organizing brain. This is a time of great opportunity for the developing child: safe, predictable, nurturing and repetitive experiences can help express a full range of genetic potentials. Unfortunately, however, it is also when the organizing brain is most vulnerable to the destructive impact of threat, neglect and trauma.

what happens when a baby doesn’t get those positive, nurturing responses? Say, if a mom is on her own with no help, or depressed, or in a violent relationship? She may really want to be a loving, responsive parent, but is that possible under those circumstances? Dr. Perry: This is one of the central problems in our society; we have too many parents caring for children with inadequate supports. The result is what you would expect. An overwhelmed, exhausted, dysregulated parent will have a hard time regulating a child consistently and predictably. This can impact the child in two really important ways. First, it affects the development of the child’s stress-response systems (see Figure 3). If the hungry, cold, scared infant is inconsistently responded to—and regulated—by the overwhelmed caregiver, this creates an inconsistent, prolonged, and unpredictable activation of the child’s stress-response systems. The result is a sensitization of these important systems.

But speaking of decisions and choices, I want to turn to a question that baffles so many of us. Why is it that people who are victims of trauma are so often drawn to abusive relationships? Let me broaden the question, because it is so important in understanding not just abuse but all behavior. 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. As I’ve said before, when we are young and our brain is beginning to make sense of our experiences, it creates our ‘working model’ of the world. The brain organizes around the tone and tension of our first experiences. So if, early on, you have safe, nurturing care, you think that people are essentially good….But if a child experienced chaos, threat, or trauma, your brain organizes according to a view that the world is not safe and people cannot be trusted. Think about James. He didn’t feel ‘safe’ when he was close to people. Intimacy made him feel threatened. Here is the confusing part: James felt most comfortable when the world was in line with his worldview. Being rejected or treated poorly validated this view. The most destabilizing thing for anyone is to have their core beliefs challenged….Good or bad, we are attracted to things that are familiar.

That question became even more salient to me as I began my clinical work with troubled children. I soon found that the vast majority of my patients had lives filled with chaos, neglect and/or violence. Clearly, these children weren’t “bouncing back”—otherwise they wouldn’t have been taken to a child psychiatry clinic! They’d suffered trauma—such as being raped or witnessing murder—that would have had most psychiatrists considering the diagnosis of post-traumatic stress disorder (PTSD), had they been adults with psychiatric problems. And yet these children were being treated as though their histories of trauma were irrelevant, and they’d “coincidentally” developed symptoms, such as depression or attention problems, that often required medication.

If the experience is familiar and known as safe, the brain’s stress system will not be activated. However, if the incoming information is initially unfamiliar, new or strange, the brain instantly begins a stress response. How extensively these stress systems are activated is related to how threatening the situation appears. It’s important to understand that our default is set at suspicion, not acceptance. At a minimum, when faced with a new and unknown pattern of activity, we become more alert. The brain’s goal at this point is to get more information, to examine the situation and determine just how dangerous it might be. Since humans have always been the deadliest animal encountered by other humans, we closely monitor nonverbal signals of human menace, such as tone of voice, facial expression and body language.

The concept of resilience is used in our field. But if you look carefully at the biology after a traumatic experience-all the way down to the way genes are expressed-trauma will change everyone in some way. And those changes will be there even if they don’t result in any apparent ‘real life’ problems for the person, even if the person demonstrates resilience. A child may continue to do just as well in school, for example, but it takes much more energy and effort. Or we may find that a child is able to return to his previous level of emotional functioning, but changes in his neuroendocrine system may make him more likely to develop diabetes. This is, in essence, what the ACE studies have demonstrated. Adversity impacts the developing child. Period. What that impact will be, when it may manifest, how it maybe ‘buffered’-we can’t always say. But developmental trauma will always influence our body and brain.

To the newborn, love is action; it is the attentive, responsive, nurturing care that adults provide. A parent may truly love his child, but if he is sitting at a computer posting on social media about how much he loves his child while the infant is in another room, awake, hungry, and crying, the infant experiences no love. To the infant, skin-to-skin warmth, the smell of the parent, the sights and sounds of her caregivers, the attentive and responsive caregiver’s actions-that becomes love. The thousands of these loving, responsive interactions shape the developing brain of the infant. These loving moments literally build the foundation of the organizing brain….the infant begins to associate these responsive people with pleasure, sustenance, warmth; her view of the world is being shaped…it is through these interactions that the child’s worldview is built, and depending upon the quality and pattern of the caregiver’s responses, will build resilience or contribute to a sensitized, vulnerable child.

There were inquiries, Congressional hearings, books, exposés and documentaries. However, despite all this attention, it was still only a few short months before interest in these children dropped away. There were criminal trials, civil trials, lots of sound and fury. All of the systems—CPS, the FBI, the Rangers, our group in Houston—returned, in most ways, to our old models and our ways of doing things. But while little changed in our practice, a lot had changed in our thinking. We learned that some of the most therapeutic experiences do not take place in “therapy,” but in naturally occurring healthy relationships, whether between a professional like myself and a child, between an aunt and a scared little girl, or between a calm Texas Ranger and an excitable boy. The children who did best after the Davidian apocalypse were not those who experienced the least stress or those who participated most enthusiastically in talking with us at the cottage. They were the ones who were released afterwards into the healthiest and most loving worlds, whether it was with family who still believed in the Davidian ways or with loved ones who rejected Koresh entirely. In fact, the research on the most effective treatments to help child trauma victims might be accurately summed up this way: what works best is anything that increases the quality and number of relationships in the child’s life.