231 – Dr. Bruce D. Perry, “What Happened To You?”

Are you ready? Let's go.

And I keep saying, it's called, what do you expect disorder?

Perry is the co-author Of several influential books, including the boy who was raised as a dog and other stories from a childhood psychiatrist, snowplow book. Born for love, why empathy is essential and endangered. And of course the New York times, number one, best seller. What happened to you?

Dr. Perry. Welcome. It's so good to meet you, man.

It's nice to meet you, Damon.

Thank you very much for being here. This is really cool. I was so happy when you accepted the invitation to join me. So I appreciate it very much.

And so I had a significant interest in biology and big part of that is Understanding kind of the life cycle of these different fish that we were fishing or the birds we were following and I was just interested in development. And I was also very interested in history. So I read history like voraciously and I really, from the moment, I think I was able to think about the way the world worked, I was always aware of the fact.

Or how did these two families end up like the Hatfields and McCoys? What's that all about? Where'd that come from?

assigned to a freshman seminar class at Stanford where I went to college. They took freshmen and they had them meet once a week with 12 other freshmen and then some senior academic faculty member. And the person that led my group was a guy named Seymour Levine, which means nothing to probably anybody listening, but he was the first person to really show that if you take a newborn.

And I, when I, learned that. I was like, wow, you're telling me that a five minute experience controlling for everything else leads to a profound difference in the way this animal responds to stress when they're an adult. And I just thought, wow, that is fascinating. So from that point forward, I've been interested in factors that influence the stress response systems in our body and how experiences, both good experiences and bad experiences shape that.

And of course, as I got older and studied this a little bit more, it was pretty clear that was relevant for just about every aspect of life. If you're going to be a physician, It was helpful to understand the stress response. If you're going to be an attorney, it's helpful to understand the stress response.

And I picked psychiatry because My mentors, who were neuroscientists, were working with some, a tiny handful of psychiatrists who were studying the brain. And, now most psychiatrists at that time were not very brain focused. And even today, they're not that brain focused. What do you

It's a little bit like you and me trying to figure out how cars work and not understanding how engines work. Right. So we would come up with all kinds of explanations and, Oh, this little keyhole thing is really important, and the reality is that keyhole thing is not that important if you know how to hotwire a car, right?

Human beings throughout history have always made up stuff and passed it forward. And Because human beings always like an explanation with no, you want to have some explanation. A lot of stuff we've invented is really terrible, right? Misogyny, racism, marginalizing and minimizing others who aren't like us.

I tie that back to what you said by pointing out that previously the adoptive parents and sometimes the biological parents, obviously the adults in any adoptee situation are the ones who control the information. They're the ones who control the story and the narrative. And so for a long time it was thought that an infant who was going to be adopted was a blank slate.

Let me just continue for one more quick moment.

Yeah. The book that you wrote with Oprah Winfrey, What Happened to You, has this wonderful opening that starts with this presentation that a child is not necessarily brought into this world with any of the biases that you just talked about. we're innately whole in that we haven't learned any kind of bias yet.

It's really important for formative things to happen at a formative time. And if trauma is introduced at a formative time, it can be completely disruptive. Do you mind talking a little bit about just that piece there, the notion of time and timing and adoptees?

the narrative of the people in power about adoption. Has definitely changed. And I think in many ways, it's so important that it has because

dominant narrative was, oh, what a lucky person you're adopted. And the reality is, it's way more complex than that.

Presented and I think that there's a whole area of adoption that the mainstream public isn't getting exposed to, I think, and I think that's why I like your podcast. I think what you're doing is so important. I think there has to be, I actually am a tremendous fan of ambiguity, a tremendous fan of complexity.

And I think if we don't sit in ambiguity and confront the complexities of life, we will continually retreat back into these oversimplistic perspectives that keep us from the truth. And. I just thought it was important to acknowledge what you're talking about. No, I

Affirmation.

Thank you.

Very simple to very complex. One of the properties of those systems is that they are exquisitely sensitive to micro environmental signals like they're intended to be changeable. And flexible, right? So neurons are flexible cells, just like stem cells are. You've probably, people probably heard about stem cells.

And so this changeability, this flexibility that we have in our body, particularly in nervous tissue allows us to cope with a whole range of environments, a whole range of environmental circumstances that are social, climate related, diet related, all kinds of things in the external world. That our human species has to adapt to.

And our brain is designed to help us do that very well. Now, the problem is you can't build a sophisticated system that's got lots of moving parts, billions and billions of moving parts and have it universally flexible, so when you're first starting to build a house. you have a lot of flexibility because you haven't picked the kind of plumbing, the kind of wiring, the kind of insulation, the kind of wood, what kind of beams you want metal, wood, whatever.

so there are things that happen to in utero that send powerful signals to our brain Helping it figure out what kind of world are you going to live in?

Are you going to be living in a world that has very consistent patterns of ebbs and flows of stress response hormones? You That, that, that are matching the diurnal rhythms of the day and minor moderate challenges of a person's life with predictable calories. Are you going to be in an environment where it's like, Hey, this is awesome.

And the longer you are in that biological parent environment and that world that they bring you into, the more parts of the house you've built And then if the world changes, you've got a house. It's prepared for one way of living and you are all of a sudden put into a different environment,

which, again, there's incredible malleability and we can adapt.

It's just that at some point the kid goes, I got steel beams. Everybody else here has got wood beams. What's going

Similarly, brain that has been developed in a woman who is not under stress of Parents trying to push her to get rid of this child and never ever talk about it again. The brain of a woman who is not under stress because the birth father that she thought she loved so much has completely abandoned her and now she finds herself making a relinquishment decision.

Any other, you name any other challenge, if the family has suddenly dissolved. That child was born and the family was in turmoil and trauma and the family has dissolved. And now that child has to move on. If the child was in your utero during that challenging time, that brain will have, it sounds like the infrastructure that is poorly adapted for what will end up being the adoptive environment, which is intended to be more supportive.

I've had a couple of adoptees tell me that. their birth mother kept them for a while, days, weeks, months before the relinquishment decision. And more than one of them has told me that they felt that was very grounding for the person that they ended up becoming. not so challenged by adoption, but more comfortable with the fact that they had been supported and they couldn't have explained it until they learned they were retained after birth is really fascinating.

So I appreciate that analogy.

So the mechanism by which the brain begins to figure out what kind of world I need to be in involves getting input from the world, right?

So sensory input, what you hear, what you smell, what you taste in that environment These signals come in and the brain begins to process those signals when certain signals co occur, when they happen together, like what a sound and a smell again and again and again, your brain pretty much starts to make what we refer to as your worldview.

Right? You're creating an understanding of the world. And then one of the most important parts of that is right after birth and in the first couple months when your brain is beginning to make sense out of the relational world because you start out in connection with another person. And you're there are these sensory inputs.

You hear voices. You hear music, you feel as you feel the rhythm

But if you're full term, And you're born for it. Your brain is primed to be exquisitely sensitive to visual input, like what somebody looks like, what somebody smells like, what their voice is, and then you begin to make your understanding of what human beings are. And so if you've got. a young parent who's been conflicted about this, but they are present and they're feeding you and they're caring for you.

the bedrock of your capacity to form and maintain relationships is being created. And that anchor that those folks felt, comes from those earliest developmental interactions with their biological parent, which builds this framework that can then be filled out later on by other people.

And then they go to a a foster home for six weeks. And then they go to a pre adoptive home. And so you've had five shifts in this primary relational experience that makes you essentially create a worldview that listen, y'all keep changing. I don't know if I can trust you. I don't know who is like, I don't know what the hell's going on.

So until one of you is completely consistent. All the time, then I'll trust you. Yes. But I'm not gonna trust all y'all.

So to cut a long story short, their father took his own life and their mother left the country. So they were sent to live with relatives and friends and other things and it gets to what you just talked about. This constant level of transition left them with the feeling of very little permanency. I won't be here long.

I'm about to roll out of here. I don't know when. And so therefore I don't need to get that attached to you. People they definitely had attachment disorder issues. And I remember specifically a confrontation that I had with my son, where after a fight with my wife, I went in and, the way I was raised in a black family out of the seventies was there were punishments for disrespect and other things.

Because no other relationship was going to be solid enough for him to rely on it. And so this goes back to what you just talked about. And I'd love to talk a little bit about two of the boys that you brought up in the book. They're Thomas and James. And they had two different kinds of traumas. adoptees because occasionally in adoption, An individual will grow up very quote unquote well adjusted.

They don't know the voice. They don't recognize the smells. None of it fits. And so they're not bonding with the mother, and therefore there's a disconnect in that family with the mother and the child. And then third, there are Adoptive situations where unfortunately a child is placed in a position that brings them trauma and so with all of those different kinds of parental engagements, I would love for you to just chat a little bit about Thomas and James, these two boys who had different kinds of trauma.

One was tally, harassed in his family and the other young man. Basically was not engaged at all. He wasn't harassed. He wasn't beaten. He wasn't yelled at. He just was not engaged emotionally. Can you talk about Thomas and James and how that plays out for the brain of a child in development?

And then, because they could not, live anywhere successfully, nobody really knew how to help them, and they went to this residential center. In the beginning of my work, and I think in the beginning of a lot of people's work, and I think to this day, many people think this, that When there's this readily observable like, oh yeah, he was in a house fire or he saw his parent get beat up or he's he got shot or this big T trauma.

And there was one kid in particular who was probably one of the more challenging kids in this place. he had minimal adversity. So one child had literally had his dad beat the hell out of him all the time. Just his dad had struggles himself, a long history of transgenerational and historical trauma in his family.

He would get fired, he'd get drunk, he'd come home and beat the hell out of the mom, the boy would try to intervene, and he'd get the hell beat out of them. And ultimately that, he came to school all beaten up, CPS gets involved, and removed him, which is probably not the right thing to do. But anyway, he ended up.

And anyway, that

He doesn't read English. He reads Russian. We're not communicating to him in his language. And so that's one of the problems with a lot of therapeutic approaches is that they're fundamentally. Relational, which I think is good. But if you don't have the relational raw material, you have to figure out a different route to help build in some of those relational capabilities, which takes a lot of, you can do it, but it takes a lot of patience.

They will tell you that as soon as someone gets close to them, they attempt to sabotage the relationship because they don't want to be abandoned. They don't want to be left neglected.

How, so how, if you could talk to an adult adoptee about this specific issue, the notion that They didn't grow up learning how to build relationships, and now is the time for them to start building this skill. What would you even say to an adult adoptee in that situation?

And I keep saying, well, it's, it's called, what do you expect disorder? In with mom, dad, grandma, whoever these loving characters are. But at some point you get the ability to crawl. Right. And the truth is, no matter how wonderful you are as a parent, at some point you're boring, I've already seen you, I've heard you.

You're boring. I want to see what's out there. Yeah. It's over there. And now that I can crawl, I'm going over there. And so what they do is as you explore the world and get introduced to new things. It activates your stress response. So your stress response is basically gets more activated.

You hear grandma and you go okay. I'm good.

but the point is you start from a point of safety in connection. So the normal process of healthy development is learning how to be comfortable, not in connection, right? How to be comfortable in connection. With when you are a little bit away and to carry the connection in your head, right? So you could, even though you're in a different room, you know that mom or grandma or dad, they're there.

Human beings, it just we belong with each other. That's just, there's just a huge part of us that pulls us to others. But if being intimate, being close, Was characterized by unpredictability or abandonment or pain or loss. What happens is we feel safest and more comfortable disconnected.

And so we go and we, we try on intimacy, and if intimacy gets too overwhelming, we push away. We retreat, we say nasty words, we blow up that connection unless we can control it. If we play the game, I want to play. We're fine. If I, if we change the rules when I'm losing, that's fine.

You have coffee and you get to know him. And all of a sudden this relationship gets the point of intimacy and it scares the hell out of you. So intimacy for you has been associated with loss, hurt. Pain and you literally you disconnect and then of course, this is confusing to this person because they're like, well, I thought we had a nice night, what happened?

I thought that was good that we're gonna do and you yourself usually don't understand it. So you come up with excuses.

Your brain hates a vacuum. So you go, Oh maybe I don't like the way he slurped his soup, or maybe I didn't, you just make stuff up,

It doesn't mean that it's a terrible relationship, but what I noticed as you were speaking and for anybody listening, you can't actually see Dr. Perry's hands. What I noticed that you did was you talked about the parent being on one side and the child moving away, exploring in the opposite direction, but that the comfort was with the parent.

And when that discomfort happens away on the right side, they run back to the parent. And what you then described was with the adult, in this case, adoptee who doesn't have good attachments. It was the opposite that there had been no good attachment on the parent side. So comfort was over here on the opposite side, in which case when they started to get into relationships that crept toward more and more towards intimacy, the comfort was over here, way far away from intimacy.

and everybody has an intimacy barrier, right?

Everybody has a certain level of you're close enough to me that this feels uncomfortable, right? And we sometimes, Jerry Seinfeld even made an episode about the close talker. The person that gets too close when they talk to you, it makes you feel a little creepy.

So you back up and try to maintain a comfortable distance. And the intimacy barrier for kids that have had relational struggles Is much bigger, the distance, the physical distance in which they begin to feel discomfort with proximity and the emotional distance is much bigger.

The kid will be new to a school and they'll go out at lunch. And one of the kids who's been in the class for the whole year comes over and says, where are you from? you'd think that's a nice attempt to engage the kid, but to the child who's new, where he's from is this is my fourth fucking foster home.

And I'm your damn business. And so that's a violation of his intimacy barrier. So he says to that kid, screw you. And the kid's like, what the hell? I mean, and so this is the kind of little things that happen all the time with these folks that kind of sabotage further opportunities to practice.

Relationships.

they blow up relationships. And what happens is it keeps them at this developmental level. That's very immature. And so the only way to get better, Damon is practice.

Right.

Give the child or the adult the opportunity to actually close the intimacy distance. They control it. As long as they can control it, then it's fine.

That's why I refer to this as either fishing therapy or dances with wolves therapy.

I don't know if any of you, I mean, some of you may remember the movie dances with wolves where there was a wild wolf that. Wanted to get close to Kevin Costner, the main character, because he had food and he was curious, and so what would happen is if Kevin Costner stayed in the same place and let the wolf wander in slowly every time Kevin tried to go over and, be close to him or stand up or give him food that the wolf would leave.

It's really important to learn how to be present and parallel patient and persistent. We call these like the four P's and with, when you give people that opportunity, then they get more comfortable with, Oh, three feet and then two feet and then I'm comfortable being right next to

And that's the beautiful thing about the brain. It changes. It'll change. But you need to have the repetitions.

And then let's try it a little bit more. That's, that's really interesting. Yeah. I'd love to ask you a different question because something that's been on my mind is the notion. So there's a mantra in the adoptee community. The lot of adoptees will tell you straight up adoption is trauma.

And this is despite the fact that we may have had a wonderful adoption, but the notion that a child is born to one set of parents, at least the mother. And then is transitioned to an entirely different life, a different woman, a different, maybe part of the city, part of the state, different part of the world for an international adoptee.

I can see why this child is traumatized because of that moment, but the people can't really conceptualize how adoption is trauma. The notion that you grow up and you don't necessarily know who your biological parents are. For me, my first biological relative was my son when he was born from my wife.

We had to make my first biological relative I ever knew. And so this idea that people think children are resilient and the notion that we're ignoring the trauma that child may have gone through is a real problem. can you say a few words? Because there was a quote that stuck out to me in the book you said, Children are not born resilient.

They are born malleable.

What does that mean?

That capability is exactly, Damon, like you were talking about earlier. It's like building muscle, right? You build resilience by having moderate, predictable, controllable stress worries. Stress is good for people, but only if it is present in the right pattern. If it's present in right pattern, it can heal people who have had stress related changes in their stress response system who are overactive and overly reactive.

That can help them heal. But also, if you have a neurotypical regulated stress response and you have opportunities for moderate predictable activation of the stress response. You build resilience. So can you just explain real

If that child had an overly reactive stress response, if they got a little hungry, it would be extremely distressed and unconsolable even after they were fed.

Now, if it starts to get abnormal, you end up in a situation where you have little stress or major response.

they have to have a transition from, lunchtime to first period or fifth period

This is like, shouldn't be a huge fight every day. And so that's disproportionate to the challenge. So

So that's a form of trauma that people would look at from a distance and go, why are they bitching? He's not traumatized.

I do believe that there's so many times when you return to that and the ambiguity and the confusion and then one of the things that happens, Damon, and I'm sure is the gaslighting that happens is like everybody's telling you that, hey, you're the luckiest kid around, look who adopted you, and you're like,

And parents will say things like, Oh, nobody wants to talk about the history. Right. They're trying to brush it aside if they don't feel like discussing it or folks will say things like it when they ask about whether they're adopted, they will make up stories about why the person is so tall.

Oh, your uncle joe was really tall. You know what I mean? So they there's these creations of story that

not with each other. You could easily discern that I wasn't necessarily biologically related to them. So, it's really interesting to think about what adoptees do endure in terms of their family and their community. But can you do me a favor? Dr Perry, just go back for a moment. Will you talk about the difference between resilience in malleability.

You gave a great example in the book of a tennis ball or a Nerf ball. Tell me what does that mean for an individual?

And so that's what happens with your ability to manage stress

You have 30 games and then you have the tournament. You're going to be more capable of performing well if you've had 30 games instead of 10. you build capabilities through challenges

And it's responsive to environmental cues and it will change in response to those cues. The issue is really the balance between unpredictable, uncontrollable, and controllable moderate.

Like what, how much bandwidth do you want to spend on things

You will feel less anxious, less distressed. And if you need a prescription for them, I'll write your prescription for them, but that's going to be more effective than taking a pill.

And then actually the, change your own oil and, put in new spark plugs, there's little things you can do to maintain your own engine.

And I've been super curious, but have never really taken time to dive into EMDR. Can you tell me what is EMDR and how is it beneficial for folks?

Network of trauma memory and some of the network is up in the cognitive part of your brain. The top part of your brain that remembers, when I was 10 years old, blah, blah, blah. And then part of it's in the emotional part of the brain that when you think about what happened to your 10 years old, blah, blah, blah, you actually feel anxious and bad again.

And then part of it's down in the brainstem, the lowest part of your brain. That you're, you literally controls your heart, your lung, your gut, and all of a sudden your heart rate goes up when you think about it. So there's this interconnected chain of memory. that's, many things can stimulate that chain.

And when that memory is really deeply embedded in your brain. It can interfere with normal life, right? So you can have all kinds of things that will remind your brain of that thing that happened when you were 10 and it might be a sound, it might be a smell.

And so now keep that in one part of your head. Here's a new thing. Remember, we were talking about how the brain makes associations between things that co occur, right? The brain takes two sensory input that's coming in. So in utero, In the womb, you're continually hearing

Pattern, repetitive, rhythmic activity, dancing, drumming, davening, all of that stuff has been incorporated in every culture. Because they figured out that, wow, when we do this, we feel better when somebody dies. We feel better when the village got burned down. We feel better when we're gonna go on a hunt or a raid.

But then at the same time, you activate that deeply ingrained, much more powerful memory of being regulated. And so what happens is you short circuit reprogram. Yeah. You reprogram. And so what happens is you can remember the event. But you immediately don't default to the bad part of it.

And so what you do is that part of the brain is getting pattern repetitive rhythmic activity. And so, Damon, if you don't do this in the right rhythm, it doesn't work.

And that's the basic resting heart rate of a human being of mom, while you were in utero.

Cause I just didn't, I didn't get it.

You know what I mean? That's the thing to think of with eye therapy. And now that you've explained this attachment of the eyes to the brainstem and the rhythmic healing processes that we go through in life, it totally makes sense now. That's brilliant. Wow. Really fascinating. Well, Dr. Perry, this has been absolutely amazing.

I would love to know just one more thing. If you're able to share, what are you working on these days? What's got you busy right now?

To just meet the needs of what's happening right now in the Middle East. And that's just not going to happen. So we really need to recognize how our cultures historically have been able to create rituals, routines, ways of living that are both trauma protective and trauma healing, and that's a lot of what we're doing.

So that's amazing. Yeah.

neuro sequential dot com.

I think that's my website. I should probably know this. And people are going to go, you may want to know

I mean, the title itself is resonant, but the content inside was just absolutely eye opening. So I really appreciate everything that you're doing. And and I'm hopeful that the adoptee community will appreciate what you've shared here today. So thanks for being here with me.

Bruce D Perry's work online. His website is B D perry.com. And you can dig deeper to learn more about the neuro sequential model. Dr. Perry's developmentally sensitive neurobiology and forms, approach to clinical problem solving for children, families, and communities@neurosequential.com. Last, but certainly not least You should check out his book called what happened to you?

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