Creating a Family: Talk about Adoption & Foster Care

A Conversation with Dr. Bruce Perry About Trauma

January 19, 2022 Creating a Family Season 16 Episode 3
Creating a Family: Talk about Adoption & Foster Care
A Conversation with Dr. Bruce Perry About Trauma
Show Notes Transcript

Join us as Dr. Bruce Perry answers your questions about how trauma impacts adoptive, foster, and kinship kids and families. Dr. Bruce Perry, is a child psychiatrist and neuroscientist, the principal of the Neurosequential Network, Senior Fellow of The ChildTrauma Academy, and adjunct Professor at Northwestern University School of Medicine in Chicago. He is the author the numerous books including co-author along with Oprah Winfrey of What Happened to You?: Conversations on Trauma, Resilience, and Healing, and co-author of The Boy Who Was Raised As A Dog.

In this episode, we cover:

  • The shift in perspective from what’s wrong with you to what happened to you--the ability to understand seemingly senseless behavior by looking at what’s behind it.
  • What do you include as “trauma”? How severe does it have to be to impact us later in life?
  • We hear foster, adoptive, and kinship parents say, “she was only neglected.” Is neglect less harmful than abuse?
  • When siblings are separated in foster care and parents are taken completely away from seeing the children for a year at a time does this lack of contact count as trauma and how does this type of no-touch abuse effect the child's brain? 
  • How common is trauma? ACE study.
  • Does trauma at a young age have longer lasting impacts? 
  • We have a child who is chronologically 3yrs, who had a non-accidental TBI at 3 months of age. He is a sweet boy but prone to rages and is very loud.  Could this be from the trauma or is it his age and frustration? 
  • How can parents help their child manage trauma if they don’t know what the trauma was?
  • The times of healing are often very short but very powerful.  And that the more times our kids experience healing, even in short bursts, the more their brain "re-develops" in healthier ways.
  • Is there is an association between trauma and sensory processing and if so, do we know why?
  • How do you become “unstuck” on being a victim?  My daughter is 18 and is struggling to become an adult, but constantly feels and acts as though she is still a victim from her past. 
  • Can you discuss how trauma is related to the sabotage of relationships, family events, life events, and opportunities?
  • Prenatal trauma—
    • in utero exposure to alcohol or drugs
    • maternal stress
  • Can generational trauma be passed down genetically through the various forms of DNA? 
  • Resilience and Healing: My question is coming from the perspective as an adoptive and foster mom of some kids who have some pretty big behaviors. Can we really grow these kids and help them live happy, well-adjusted lives?  Not problem free, but a life where after many years of love, they will come to find peace within themselves?   
  • I have two children who are currently in foster care because their father was abusive and I stayed with him and allowed my children to witness the abuse. Is there any way to reverse the trauma?

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Please pardon the errors, this is an automatic transcription.
0:00  
Welcome, everyone to Creating a Family talk about adoption and foster care. I'm Dawn Davenport. I am both the host of this show as well as the director of creating a family.org. Today we're going to be having a conversation with Dr. Bruce Perry. Dr. Perry is a child psychiatrist and neuroscientists. He is the principal of the neurosequential network and senior fellow at the Child Trauma Academy and adjunct professor at Northwestern University School of Medicine in Chicago. He is the author of numerous books, including co author along with Oprah Winfrey, of What Happened to You Conversations on Trauma, Resilience and Healing, as well as co author of the boy who was raised as a dog. Welcome Dr. Bruce Perry to creating a family or maybe I should say, welcome back. Since we've, we've talked with you in the past.

0:51  
Sorry, thank you for having me appreciate the opportunity.

0:55  
Well, I, as I probably heard from a lot of people, I have thoroughly enjoyed what happened to you, and was so thankful that you wrote it. And I love the shift in perspective, which is kind of at the heart of the book, from looking at what's wrong with you, or what's wrong with him her, are they to what happened to you or to them? It's that ability to understand the senseless behavior, potentially senseless behavior by looking at what's behind it. And I think that's the heart of, of having being trauma informed. We

1:30  
do agree. I think that's a huge part of it. I, you know, at the core of what I think are trauma informed approaches, is an openness and curiosity about the person rather than having kind of a judgmental perspective. And I think that, you know, obviously, your listeners, and you know a ton about this, because that's really, at the heart of understanding foster and adoptive youth and children, that they've been through struggles, and that's playing a role in how they're functioning in the present.

2:06  
So what do you include as trauma? I mean, how severe does it have to be to impact this later in life?

2:13  
Well, you know, Don, one of the biggest problems our field has had in the last 20 years is coming up with sort of a consensual agreement about what trauma means. And we still have that, you know, there are people in our field, we will hear people, both in a professional environment, but really more kind of in the lay population, people will use the word trauma in a way that is different than the way you and I might talk about trauma. But the, from my perspective, one of the most important parts about that whole debate is to pay attention to the three E's, which really were part of what a big consensus panel of experts in the field got together were convened by SAMSA. And over time, came up with what I think is a really useful way to frame in understanding of trauma. And the first one is, obviously you want to understand the event, or the events. Sometimes there are huge major, obviously events like yesterday was the anniversary of Sandy Hook, that's pretty obvious, yeah, big event, where you can imagine that that would have a traumatic impact on people who were close or impacted by that event. The second thing is, is an experience. All of us know that you can have multiple people in the same event, but they will have a very different experience. And you know, it's interesting, because this is actually also very relevant for our work that you may have a child who has a neurodevelopmental problem, let's say autism, and the event that's dysregulated for them, that makes them feel overwhelmed might be a birthday party. But most people would look at the event and go Well, that's not a trauma going to birthday party should be fun. But the internal experience for a child with autism, of being at a birthday party where there's all this uncontrolled overstimulation and relational stuff swirling around, could literally make that child feel so distressed that it could have a have some long term effects, which is the third E. And so this is part of the dilemma. This is part of what we're trying to study right now is, how is it that one individual is able to weather a lot of these obvious adversities whereas other individuals are exquisitely sensitive to transition, unpredictability, chaos and so forth. And that's a big part of what we're trying to learn more about.

4:52  
And I hope will be the subject of your next book. The whole idea of resilience healing and and what we can Do About It. You know, it seems like that's, that's important. We hear foster adoptive and kinship parents say, and I'm using this with air quotes, well, she was only neglected, is neglect less harmful than abuse.

5:15  
I actually think neglect is worse than some sort of action, some sort of like traditional physical or sexual abuse, neither one of those are good. But the problem with neglect is that if during development, you don't get sufficient stimulation in certain systems in the brain, and then you miss these critical Windows during development, the opportunities to provide replacement experiences become harder and harder and harder and harder. So in many ways, the long term impact of neglect tend to be harder to identify and harder to treat. So, you know, neither one of them are good, you know, it's not good to have sort of a big abusive event. But part of what we've been finding and, and many other people in the field have seen is that you can have a lot of these adversities that people go out, that's bad. You know, you got physically abused, you had poverty, you went from home to home. But we look at the individual, and they're doing pretty well. And then we look a little bit more closely, what we realize is that all through that there were solid connections to healthy people. And it might have been somebody that was in their church community, it might have been somebody who was our kin, it might be a coach that took a special interest in the child and sort of brought them into their family sphere, and provided this connectedness that was able to buffer some of the adversity. So you know, we're continuing to try to tease this all out. And human development is very complex. And this is why, you know, we have a lot of incomplete answers to these very important questions.

7:04  
Yeah, that that makes that makes very good sense to me, we talked about the power of one, you know, one caring adult and a child or youth life can make such a difference in that child's ability to to both survive physically, of course, but also emotionally,

7:19  
it's interesting to know that this, there's something that we should talk about there that we talked about the power of one, and I just talked about how, you know, even when I talk about this, when I teach the presence of a safe, stable relationship, can can buffer some of the adversity and can provide a healing environment. But I don't want people out there, when they hear that, hey, if I was only better at being connected, then all the problems my child has would go away. You know, part of what, what we need to continue to focus on is that not every child that comes into your home is starting at the same point. You know, some of the kids are so far behind developmentally, and so dysregulated, that you can be a great parent, and they'll still struggle. And so your presence is helpful for them. And your presence is helping them do well. But you're not going to see the kinds of rapid progress or what you really want. And I think a lot of parents beat themselves up because they're hearing out there that hey, you know, it's just connectedness. Yeah, just a relationship. And they're like, Well, what the hell I mean, I'm, yeah,

8:31  
I'm doing it. Exactly.

8:33  
I give my whole life to this kid, I sacrifice my bridge club, I sacrifice going to work out of the gym. I go to the school three times a week and talk to counselors, you know, that, and still, my child struggling. And so I think it's important to remember that it's not just, you know, that presence, it's that your presence is a necessary element of healing. But it's not the only thing. That is that has to go into the stew to make the sort of heal.

9:06  
If only it were that easy, that we could just say this is the one thing but as you say, We're just much more complex than that. Let me pause here for a minute to tell you about a free educational resource that we're offering you. Thanks to the jockey being Family Foundation. We now have 12 free online courses available for the listeners at the creating a family.org podcast. You can go to our online Parent Training Center and the easiest way to get to the free courses is to use this link Bitly slash JPS support that's bi T dot L y slash JBS support. You can see all 12 courses and they are all free to you. Thanks Jackie being family. We got a question from Kenya kind of in the the general genre of what counts as trauma. Kenya's question is when siblings are separated in foster care, and the parents are taking completely away from seeing the children for years at a time, does this lack of contact count as trauma? And how does this type of what she calls no touch abuse affect the child's brain?

10:17  
Well, there's definitely, you know, if you look at the impact of these relational ruptures, whether it's from even from your biological parents who may have been less than ideal, and then your siblings, that these have impact on the way you function. And in some cases, it might reach the level of what we would call trauma. It's again, it's very, very kind of complex. But there are cases where a sibling may have been abusing another sibling. And so when those two are separated, it may actually allow the child who's been being abused by a sibling to get on a healthier trajectory. And so in that way, that might have been a very positive separation. In other words, times, there are siblings that are providing kind of these parental FIDE interactions, they're protective, they're supportive, they, they care for these kids, their siblings, and then when when those kids get separated, that can have a tremendously devastating impact. And so this is why we always talk about the need to get to know the individual child and their their individual story. And what you will be able to do then, is make better decisions about what kind of home what kind of services, what kind of separations are going to be tolerable. And which ones are going to be potentially therapeutic and which ones are going to be potentially catastrophic. Because we all tend to view these issues in a categorical way, you know, so people say, Oh, he doesn't believe in separation, or, Oh, he's it only care, you know, he thinks kinship is the only way to go. And I think any of that is just inaccurate, that you really need to try to find, understand the child's specific journey, and then look at what are your options and make the best decision based upon that. And there are times when kinship, there's no healthy kid, I mean, that just, it's just the unfortunate reality.

12:27  
Or the kid who is around as we've been doing listening sessions, and we've had a number of great grandparents who are raising children that had been in our lizard listening sessions. And these the ones that were there were great, but you know, they can just be just age alone can make

12:44  
exactly right, exactly. And this, and this, again, sort of makes the work that we all do so important that when we do put somebody with elderly grandparents or great grandparents, we need to make sure that we don't leave those individuals alone. To do this. We need to shore them up, we need to give them resources and create a sort of this caregiving environment that has adequate supports for everybody involved. And this is, unfortunately, we're terrible at that. We tend to sort of, you know, we'll take a really challenging child, and we'll put that child with a family and then we'll just disappear. Mm hmm. You know, and the system will go hey, good luck with that.

13:25  
Mm hmm. And then we wonder why the children end up back in the system.

13:30  
Exactly, exactly. We're just we really need to be more systematic and more thorough, in the way we understand and try to help these children and the families that are trying to help them.

13:41  
Yeah, I'm giving you a standing ovation right now. I agree. Amen. Does trauma at a younger age have more longer lasting impact or less, because they're, you know, they're they're so young?

13:57  
Well, from everything that we've seen, and everything that is being reported, the younger you have adversity, and the and then the, the pattern is important, as well. So younger and more chronic, leads to more problems. And it really has to do with the way the brain develops, you know, the brain develops very rapidly in utero, and then in the first years of life, and so when you have these catastrophic or less than ideal developmental experiences during those times, that's just gonna make the biology of the brain have a harder time organizing properly, and then that has this huge cascade of additional problems. So, in general, the earlier the adversity or the neglect, the more catastrophic it is.

14:48  
All right. That leads us to a question from Nancy she says, we have a child who is chronologically three years old, who had a non accidental traumatic brain injury at three months of age. He has cerebral palsy left him aphasia, global aphasia, grand mal seizures, and his comprehension is about at the 18 month level. He is a sweet boy but prone to Rages and is very loud. Could this be from trauma? Or is it his age and frustration? He has been in our care since two weeks post trauma discharged from the hospital, his mom is developmentally delayed, as is his dad, and he is also prone to anger. So she's trying to figure out if this is his age, and the fact that he has these disabilities causing him to have frustration, or at three months, in the trauma that the significant trauma he had it three months is the reason? Well,

15:46  
here's the dilemma. There's not one reason, you know, the human behavior is very complex. And I heard multiple potential factors that would plausibly be involved in the impulsivity and sort of anger and the dysregulation stuff that that you mentioned. And this is why, you know, when we do our clinical work, we have an assessment process that tries to give us sort of this, this snapshot of the way the individual's brain appears to be organized and where it is developmentally. And then we target the approach to where the child is developmentally as opposed to where they are chronologically. So if this child is developmentally like an 18 month old, they're kind of entering the terrible twos. And so even under normal developmental trajectories, this time period, is characterized by these kinds of storms of behavior. And if you add in that difficulties with communication, the difficulties with movement, the difficulties with past trauma history, there's a lot of it's like a perfect storm. So that's kind of what I've been, that's what I would think is going on. Now. With all that said, the good news is that when the brain is is has compromised, that comes from any of these routes, there's still hope, that with developmentally targeted interventions, that there will be progress. And the good news from the question is that this family clearly understands it. You can be chronologically one age, but developmentally another age. And I think that as long as they're patient and consistent, and do their very best to provide an array of developmental opportunities for the child kind of meeting him where he is that this child will make progress.

17:50  
Stephanie asks, How can parents help their children manage trauma if they don't know what the trauma was, which, honestly, for a lot of our families, we may have an inkling we may not, we don't know, oftentimes, and oftentimes, our kids can't tell us either.

18:08  
So that the vast majority of people who have developmental trauma, you will never know what the trauma was, you just will never know. You may as they get older, to get some clues, you know, if you find a specific set of interactions or activities, make them really reactive and kind of make them blow up, then you might go out, it seems like he's really sensitive to men, or he overreacts under these circumstances. And you can get little clues. But the reality is, even with adults, we don't always know the full trauma narrative. So the good news is that really, in the end, is not going to get in the way of treatment. The key thing for treating trauma is to really provide consistent predictable, nurturing experiences that help these systems that are overly reactive become less reactive. And that doesn't really require a traditional use of cognitive storytelling that just doesn't require that you have that traditional cognitive behavioral approach. If you use a somatosensory regulatory strategy, these kids and adults can start to get better regulated, and and sometimes when they get better regulated, there will be parts of their cortex that open up and they'll actually remember more. So at that point, you can then start to weave in more traditional cognitive and insight oriented work. But it's not necessary to know the trauma. I would encourage the reader to go go read Bessel Vander Cooke's book about the body keeps it keep the score. Yeah. And it really, you know, best one I've talked about this a lot that it really is His words can be very important and words can be healing and cognitive behavioral therapies can work. But if that's usually if you have sort of this clear delineated experience that took place while you were old enough to make the memory, the cognitive memory, but if you were to 18 months, you know, just you can't make the kind of memory is going to be accessible with traditional cognitive behavioral therapy. So we rely upon these bottom up strategies, which actually turned out to be very, very successful in per useful.

20:39  
You mentioned it, I didn't write it down semantics sensitive, I didn't think I missed part of it type of approach, what do you say it again, so that I will get it correctly? And what do you mean by that

20:50  
somatosensory, basically, what I mean is therapeutic approaches that use the body and your senses to get into the brain. So when you move your body, like when I sway back and forth, I'm actually activating systems in the lower part of my brain, that are involved in attention and arousal, and the stress response. And so when you see a child who's rocking themselves, they're trying to self regulate. And again, you know, lots of people have written about it, but the most direct route to the, to these core regulatory networks in the brain that are involved in stress and, and mediate most of our trauma symptoms, the most direct route is through sight, sound, smell, touch, and internal signals, interoceptive signals like movement. So when you dance, when you listen to music, when you play with clay, when you do all kinds of things, that you're not talking about the trauma, right, but you're doing pattern, repetitive, regulatory things that can help you heal. And that's, you know, there are a lot of approaches that people use animal assisted therapy EMDR. You know, there's a whole Pat Ogden, it's got a whole somatosensory package of treatment approaches. And again, there are a lot of different therapeutic techniques that get to those parts of the brain, but a lot of them are similar ot sensory diet, or therapeutic massage, you know, all kinds of things that are less talking and more being. And I think that that helps a lot of these kids.

22:35  
We had a number of discussions, but in one in particular, about the book, what happened to you on our online support group, and for those in the who are listening who may want to join us, it's at facebook.com/creating a family. And I wanted to read some of the one of the two of the comments that we got, this is from joy, she said, one point in the book that was particularly encouraging for me was that times of healing were very often short, but powerful. And then Tracy chimed in. And she said also, that the more times, our kids experience healing, even in short bursts, the more their brains redevelop, in healthier ways, I thought you could talk some about that, that was so encouraging for so many in our audience.

23:23  
You know, as I came into clinical training, with advanced training in the neurosciences, and what I've been studying, and what I knew a lot about was that the neurons and neural systems and the way they work and the timeline for causing change in the synapse in the synapse, which is really what is the the mechanism underlying learning it learning a memory and Therapeutics is changing these the neurobiology of these systems. And what I knew from that work was that a meaningful stimulus that could lead to change was literally seconds long. And so I had that in the background of my brain as I started to do clinical work. And when I was doing clinical work, it was like, Oh, you go see me as the therapist once a week for 15 minutes. And somehow in that 50 minute session, I was supposed to do something that would result in changing the brain of this child. And in the beginning, I kind of did what I was told, and, you know, had this fantasy that I was so powerful, and I was so great at what I did that my magical hour was gonna change everything.

24:32  
Not an hour. 15 minutes. Nope. 15 minutes. You were gonna get it done in 15 minutes by gallery.

24:36  
Exactly, exactly. It's so after I got off my arrogance chair, I realized, well, this is this is craziness. This just can't work. It just and so I started to look around and see that the kids that were doing well are the kids that were connected to a they'd been in foster care with a one family for a year and they They connected to a sports team. And they were part of a community of faith. And I started realizing, Wait a minute, they're not getting therapeutic moments from me, I mean, I might get a couple moments when I'm really right there. And there's this, there's this intense sense of presence and connection. But that usually was pretty fleeting, and pretty overwhelming for the kid. And then they'd sort of back off and they'd wander around in a play, and then they might come back and then talk about something. And so even in a good 15 minutes session, you might get two or three of these little moments where you really thought something was happening. But what I realized was that every day when this child was heard, and listened to by the foster parent, and tucked in at night, and let me wash your hands, and let's wash our hands together, and the coach would say, good work. And in all of these little moments, were what was making the therapeutic change. It wasn't my magical hour. And so we started to look at that much more carefully. And lo and behold, every other discipline that was looking at health, not just mental health, but physical health was showing that connectedness, you know, being being connected in safe, stable and enduring relationships was the best predictor of physical health, social health outcomes, mental health outcomes. And it was a tremendous counterbalance to adversity. And so we started to look at this more carefully, our clinical approach now is very intentionally, external to the therapeutic hour, we intentionally help the coach, the teacher, the parent, of foster parent, understand the child that better, so that they can have more of these moments. And everybody is listening, you know exactly what I'm talking about, you know, those moments were like, you know, you might be going through the routine or like the after schools thing. And then they'll just be this moment where you really are fully present with them. And they'll open up about something that was hurtful in class, and you'll do your best to kind of make comfort them and make them feel better. And then three minutes later, they're off to go do something else. But that that moment, that minute, that therapeutic moment, that's what endures. And that's what is changing the biology of the brain. And that's what's healing these kids. It's not me, it's you. And and that's what I want people to understand is that the majority of therapeutic change takes place in non therapeutic in non therapy relationships. Mm hmm.

27:38  
But the training of the parents and helping them understand if nothing else, the power that they have, is important work. Absolutely. Mary asked, is there an association between trauma and sensory processing? And if so, do you know why she wants to know?

27:54  
First of all, then the answer is yes, we know that as the brain is organizing, and all of your sensory input comes into your brain separately. So touch and smell and sound, they all come in separately. And they come into a part of the brain that is also has these important centers that are involved in stress. So an individual who is either in utero or early in life experiencing stress, will have stress related inefficiencies in how these sensory connections get made. So as you get older, your brain starts to connect, sight and sound and smell and touch and taste. And then you kind of weave all that together to make sense out of the world. But that process can be interfered with by distress. And so trauma related experiences will interfere with the normal synchronous development of sensory integration. And then that, again, has this whole cascade of impact in the brain develops from the bottom up. And so one of the key things that happens early in life is that after you get this primary sensory integration, that helps you learn from all kinds of other new experiences. But if that primary sensory sensory integration is kind of inefficient, and not normal, then you can't benefit from subsequent new learning experiences the same way. And so it kind of leads to this cascade of risks. But again, it's very much related to developmental trauma.

29:32  
Don't you just love the way that Dr. Perry walks us through a deeper understanding of of the impacts of trauma? If you're enjoying this, please subscribe or follow to the creating a family podcast we have more interviews such as this we cover the topic of trauma recover the topic of abuse, neglect, and how it impacts children. On many of our shows, we have an extensive library archive library because we've been doing this podcast for, believe it or not 14 years. So we have an extensive archive. So please go to whatever app you're using to listen to this and subscribe or follow creating a family. We have two questions that are I think related, so I'm going to read them both. Terry asks, How do you become unstuck on being a victim, my daughter is 18 and is struggling to become an adult but constantly feels and acts as though she is still a victim from her past. She can't get past being a victim and struggles with manipulating others and self loathing behaviors, she almost always finds a way to not be happy. The backstory here is she was a victim of domestic violence, sexual abuse, neglect, physical abuse, lack of food, emotional cruelty, she was removed at age five, and adopted along with her brother at age nine. A similar question, or similar feeling anyway, is from Robin, she would like to know if you could discuss how trauma is related to sabotage of relationships, family events, life events and opportunities.

31:10  
Yeah, well, both of those questions are sort of touching on things that are very commonly seen in kids that have really tough developmental backgrounds, particularly when the abuse took place in context of these primary relationships that are supposed to be keeping you protected and feeding you and making you feel loved. So one of the things that happens as the brain is developing is that you start to try to make sense out of the world. And I kind of mentioned it earlier, even at this primary level, you're trying to connect, what you see with what you hear, and what you hear with what you feel, and what you weave together all this sensory input, and you begin to make what we call a worldview. And one of the primary most important worldviews you create is about what people mean, you know, and because people are such a primary element of your first experiences, so your brains trying to figure out what is this thing that Hoover's around and has two eyes and a nose and a mouth, and they say things and sometimes they smile. And so your brain begins to get some understanding of what people are. And that primary organizer of your worldview about peep all people is your primary caregiver, which, let's say, in this case, might be a mom. But if the mom struggling, and she's in a domestic violence relationship, there's also another human being that's that all of a sudden, blows up the the ability of your mom to be attentive and attuned. And so she'll be preoccupied sometimes. And she'll be absent sometimes. And she'll be crying sometimes. And so your brains like, I'm not getting a consistent signal here about what people make. And sometimes my needs aren't met. And sometimes I'm scared to death, I don't know what's going on. And so your worldview starts to become that the world is a chaotic place. And it's unpredictable. And sometimes people will be kind. But then they'll leave and they'll disappear. And then sometimes people will get too close to you, and they might hurt you, they might kiss you, you don't, but you don't know which one is going to be. And so as you get older, and you have some agency, right, you have some ability to control relational interactions, you start to do things to keep people keep all your relational interactions controllable. So if the little child down the street wants to play with you, you want to be connected, because there's this powerful pole. But you have to play the game I want. And if you don't play the way I want, then I'm going to call your names, then I'm going to push you away. I'm going to control that I don't I would rather control you coming and going then have something uncontrollable happen. And so they develop these very maladaptive techniques that have this weird push and pull. A lot of these kids develop the capability as they get older, to make relationships. But then the relationship if it doesn't, if they can't control it, then they vilify that person. Mm hmm. And, you know, this, everybody who's an adoptive parent has, not everybody, but many people have had the experience. They're the person that they love you the most. And yet, they can't manage this intimacy, and then they also are the vilest to you, they'll push you away. They call they say the most hateful things to you. And then an hour later, they want to crawl on your lap as if that didn't happen. And so this this Weird need their worldview is starts to influence the way they do everything they do. And again, depending upon a number of things that it can start to influence how they view themselves, they'll be self loathing because they're like, Why do I always blocked these relationships? I don't quite understand it. And they start to go, I must be bad, I must be like this, I must be that. And then of course, their sense of themselves starts to get influenced by this primary relational difficulty they have. Now, that's, again, that's sort of a thumbnail overview of why some of this stuff might happen. The other thing that we all see with these kids, and not all of them, but there's a weird thing about your brain. Once you develop a worldview, your brain likes your worldview.

35:52  
It's safe. I mean, it's what is your worldview? It's Yeah,

35:56  
exactly. That's exactly right. And so when your worldview is that people are unpredictable, people are out to hurt me, people are all of this all the world's unsafe, and you get into an environment where Wow, these people are consistent, predictable, kinda nice. There will be both conscious and unconscious efforts to prove that your worldview is right. So there will be provocative behaviors, that will provoke the world into punishing you or yelling at you, or, or you figure out how to cause chaos. And then then they go see the world's chaos. And these kids get really good at that. And it, it seems so puzzling, because here they are, in an environment where there's safe, pleasant, positive things. And they'll blow them up. And we go, What in the world is going on. But it's a lot of it, I think, is related to this, just that the worldview we create early in life is as a powerful hold on us, and can change, but part of what this is where words do become helpful. So once you get a young adult who's doing this, and you teach them a little bit about how the brain works, and how the brain develops, almost all them go, oh, wow, that's what I do. And you go there. And then and then you in, then you can talk about Well, is there, let's talk about a strategy to change that. And one of the things, the strategy I use a lot is that I try to take particularly around me, I'm a victim, you know, world's been hard to me, blah, blah, blah, I actually think many of these individuals do better and begin to heal, when they actually get into serving and helping relationships. So I will ask them to help me work with a child is younger, who also went through really bad things. This kid needs somebody to help them with his homework. He's two grade levels behind, and you know what that feels like? So how about if we pay you $15 an hour to tutor this kid. And pretty soon they have a sense of responsibility, they start to see little elements of, you know, it's, it's, it's like looking in a mirror sometimes. And then they can engage, it's very rare that they that they use that relationship in a pathological way. They almost always feel more competent, they feel comfortable, they take pride in helping this other person. And, and that's, that's what we find. So we'll have somebody who's really good at sport, will get to have them. Coach, a kid who wants to play basketball or a coach, a kid that likes the sport that they like, but is a little bit less developed than they are. And so it's, you know, we do this all the time. So a lot of these kids, let's say you've got an 18 year old who reads at a 12 year old level, and they think I'm stupid, why should it be in school, blah, blah, blah. And we tend to send them off to a tutor to help them. But what we do is we say, Hey, you read at a 12 year old level, we got a nine year old who reads at a six, six year old level, we want you to tutor him. And so reading gets reframed as something that they're good at as opposed to something that they're mad at. And they start to take pride in that. And then pretty soon Reading isn't something that they avoid, they actually kind of like reading and lo and behold, before they know what they're reading at a 13 year old level, and then a 14 year old level and these two progress together. So that's the kind of thing that we try to put in place.

39:41  
I want you to tell we were talking about trauma at an early age and why that is more impactful. I wanted to back us up even further and talk about prenatal trauma. I mean, it could come from any number but we're doing quite a bit of work at creating a family on in utero exposure to alcohol and drugs. And then of course there maternal stress as other types of, of prenatal trauma. Has there been much research on on that. And of course, there has been on the the impact of alcohol and drugs on the developing fetus, but just trauma in general and happening

40:14  
in utero. There's more and more work being done, done on looking at cohorts of children, where the mother was significantly distressed. Now, that part of the problem is this is that usually when there's been a lot of stress for the pregnant mother, you're also going to run into they smoke and they drink. Yeah, the reason there was stress was they were in a bad relationship, and they got beat up. So we had a study once where we were trying to look at this, and it was just so calm. I mean, we had

40:47  
at ET. Yeah. Is it stress? Or is it the fact that they're drinking and doing drugs to self medicate to control the stress? Or that they're in? But yeah, exactly. Yeah.

40:59  
And so that's one of the reasons that we have this huge data set, we've got a big clinical assessment model, that's looking at this across, we now have 90,000 cases, because in order to kind of get the numbers that you need to look at this the right way, you have to have a wide reach. And so we're only believe it or not, with 90,000 cases, we're just now getting to what I call the adequate numbers to look at that carefully. That makes sense. And so what we are finding, though, is is exactly that, that these kinds of studies, and then some very interesting retrospective studies that were done, when a large population was just

41:42  
going back to the World War Two support. Exactly right. Right. That's

41:46  
exactly right. So we it's an emerging field. And I do think that everything is pointing towards the the impact of stress and distress on the on the mother as having the ability to have some epigenetic changes in that, that lead to increased risk. But it's, you know, this is one, this is a story that will unfold, you know, over the next 10 or 15 years, as we get better techniques, to look at this,

42:15  
as your research develops, reach out, and we'll try to help publicize it, because I'm fascinated by that. It does this fit within the whole nature of generational trauma. You know, many of our adoptive Foster and kinship kids come from families where their parents have been abused and neglected, and not infrequently were in the foster care system themselves. And even in international adoption, there's, you know, war and parents who have been raised in institutions and things like that, and, and now their child is. So does this, is that fit within what you're talking about, about generational trauma?

42:51  
Absolutely. And it's, you know, again, as we look more and more carefully at what are the determinants of how we're functioning in the present, you know, what are the determinants sitting, that make you at risk for heart disease, what are the determinants that make you at risk for, you know, diabetes, it, we can kind of pin a little bit on genetics and a little bit, and we can, we're now able to kind of look at, you know, diet and other habits, but it's turning out, as I think everybody who's listening probably knows that the pattern, the nature of adversity, during your development, play a major role in your physical health, and in other lots of really important parts of mental health. But as we look even further back, it turns out that the experiences of your grandparents and your great grandparents, probably also play a major role in some of the risk that you experienced for a variety of mental health, social health and physical health issues. And again, this is this is an emerging field, in animal models, you know, we can study, you know, four generations of mice pretty easily. And we can control diet and environment and stress or send genetics and look at this. But in human populations, oh, my gosh, I mean, we're complex. And so we just get these little snippets of sort of promising studies that that point this out, but I think there's no doubt right now that there's a heritability to traumatic experience and adversity. And part of that heritability is epigenetic and part of it is in the way you parent. And, and so I think both of those are very important. And again, our experiences very much like what you're describing, in the most challenged kids that we work with their parents who've really struggled being good parents, they grew up in environments that were terrible. And then you look at their parents and so we actually have some interesting data of four generations of transgenerational trauma where we've looked at this, and one of the heartbreaking things we see is that as a child, and this has happened in a couple of generations, as a child starts to heal, basically, and get more developmentally mature and capable than their parent, the parents start to undermine the child's progress in ways that are sometimes subtle, but a lot of times in ways that are really overt and very destructive. And so those of you who do clinical work out there, one of the things that you may have seen is that you'll have a child and you start making progress, and all of a sudden, the parents stops bringing in the child. Mm hmm. And what you find out is that the parents almost jealous of the attention or the parent is, doesn't want a child who's more developmentally capable than they are. And so they, they undermine the process. And again, this is something that we have to think about, in the way we construct our interventions. So we have to do more to help the parents. And I think that if we did that, then we would have an easier time helping their kids.

46:14  
I want to thank one of our long time partners, the Vista Del Mar, they are a licensed nonprofit adoption agency with over 65 years of experience helping to create families, they offer homestudy only services, as well as full service, infant adoption, international home studies, as well as international post adoption support and a foster to adopt program. You can find them online at vista del mar.org/adoption. Well, I want to end on by two questions that are on resilience and healing. Because I, I feel like that's the key. And that's one of the things I love most about the book. But I want me to take these two questions separately, because they they're coming at it from different angles. One is from Carrie, she says, my question is coming from the perspective as an adoptive and foster mom to some kids who have some pretty big behaviors, we are doing everything we can providing an incredibly loving and stable home, participating in therapy, great School Support Site cooperation with some meds being used a good relationship with their bio parents, I am just looking for encouragement, can we really grow these kids and help them live happy, well adjusted lives, not problem free, but a life worth after many years of love, they will come to find peace within themselves. It's really hard right now as they are four and seven years old. I would just love to hear some success stories. I read what happened to you. And it was the best resource I have read so far. So I want to say thank you. So do you have words for Carrie?

47:53  
I do, Carrie, first of all, thank you for your kind words about the book, and for doing what you're doing. Because it really will make a difference, these kids are going to grow up and they're going to be they're going to find a niche. And they're going to be able to make the world a better place. It's there's no doubt about it. If you look around, it's interesting how many people have gone through really hard developmental challenges, and some of them have never, ever really formally entered our systems and ended up doing okay. And and a lot of them. You know, I remember, there was a minister when I was growing up, who was like one of the pillars of our community. And I didn't find out that he was raised in care until later on when I became a professional. And I was giving a presentation in my hometown. And he said I was one of those kids. I said really, I was just shocked. And because so much of our focus is on the bad stuff, right? The bad outcomes. But the vast majority of kids who have these hard starts and get into a home like yours, do well. They struggle, but we help them with the struggles, you know, and they may not be exactly you know, they may have a little imperfection here like who doesn't, right? Yeah. And but they'll find a niche. And more than anything, what will stick is the way you love them. That's what will stick. They may not be math geniuses and they may not you know, they may have aspirations that they don't need, but we all do. But what they remember is how the people around them love them and cared for them and and that's what they'll carry forward. And that's really what matters in the end, I think so that yes, they do get better. And there's lots of success stories. I mean, Simone Biles is a great example. There are many, many, many people in an in the public eye who grew up in the system and grew up falling trauma and who are doing pretty well.

49:55  
And our last question is from Ashley. She says I have two children. aged eight and six who are currently in foster care because their father was abusive, and I stayed with him and allowed my children to witness the abuse. It ranged from name calling to locking me in the basement for multiple days withholding food from me, I was finally able to break the trauma bond and left him in February of 2021. And was found fit and August at court. And we'll be getting my babies back in January of this next year, which is a blessing I am beyond grateful for. But since I allow them to witness the abuse, it also taught them that the behavior was acceptable. And now they both have behavioral issues. They think it's funny to intentionally upset me and laugh when I try to explain how I feel about the way they're acting or behaving. They hit me and they throw things at me. I know they act this way, because I allowed their father to behave the same way, showing them that it was okay. But I am trying so hard to help them understand that none of what their father did was okay. Is there any way to reverse the trauma? Is there any hope for my babies? Is there anything I should be doing that I am not?

51:05  
Well, first of all, I think it's wonderful that you made that decision. And I think you're going to be a wonderful, continue to be a wonderful parents as you move forward. Even in the question, I can kind of get a sense that you're a little hard on yourself. First of all, it's going to be important that you reach out and get help for yourself, and you get help for them. And there's nothing wrong with that. They need to learn healthier ways of expressing their emotions, healthier ways to interact and get what they want. Which they which they can, you know, but you need to not put the entire burden of that on your own shoulders. Take advantage of the schools take advantage of the mental health system, if you can connect with it, to help you do that. And then just don't beat yourself up. Be patient with yourself and get the help. You need to kind of get over this because you had lots of trauma. Now and again, the good news is there's every reason to believe that you can get past this. People can learn children will learn I mean, your children love you and they want you you know, in the end, they want to have a healthy, peaceful environment. And it'll it'll happen, but it takes time.

52:27  
And you know, I also was thinking and reading Ashley's question, the other thing, she's also modeling for them someone who did break the break out of a she's modeling, yes, she may have modeled acceptance in a bad way. But she's also modeling that that you can change and exactly how powerful that would be. What a wonderful lesson. Absolutely. Well, thank you so much, Dr. Bruce Perry, for being with us today. I love the book I highly recommend for everyone to get it. What happened to you conversations of trauma, resilience and healing. Thank you so much for being with us today.

53:02  
Thank you for having me done. Keep up the good work.

53:05  
Thank you