Three Lessons I’ve Learned About Developmental Trauma

A few of my learnings from spending (way too much) time reading about the neuroscience behind trauma

1. Developmental trauma is pervasive…and as a society, we are woefully uneducated in how we approach care for ourselves and care for others who have experienced any degree of it. Many people are quick to say that they have never experienced trauma in their lives. And while it is certainly true that some have never experienced what I’ve learned to call a “Big T Trauma”, the reality is that so many of us don’t recognize the “little t traumas” that have indeed shaped us throughout our lifetimes.

Developmental trauma is an area that few outside of those in psychological circles truly understand, and given its prevalence, we should all dive much more deeply into the science behind it than we do. In “What Happened to You?: Conversations on Trauma, Resilience, and Healing”, by Dr. Bruce Perry and Oprah Winfrey, Dr. Perry shares that “a recent study by the National Survey of Children’s Health found that almost 50 percent of the children in the United States have had at least one significant traumatic experience.” He goes on to name that a more recent study conducted by the CDC “found that 60 percent of American adults report having had at least one adverse childhood experience (ACE) and almost a quarter reported three or more ACEs” — and notes that “these numbers are even more sobering when you consider that the CDC researchers believe them to be an underestimate.” ACEs are defined as potentially traumatic events that occur in childhood; examples include witnessing violence, experiencing detachment from a caregiver due to divorce or abandonment, living with someone struggling with addiction, and experiencing mental, physical, or emotional abuse in the household.

The reality is that many of us have experienced a significant event in our early years that shapes how our brain develops — and therefore how we come to interact with and relate to the world around us, including in our relationships with others.

The results are truly devastating. The CDC has shared that at least 5 out of the top 10 leading causes for death are related to ACEs, and that preventing ACEs could eliminate up to 1.9 million cases of heart disease and 21 million cases of depression, among other types of health-related impacts.

Developmental trauma is an epidemic that our country is not currently systematically addressing with the type of urgency it requires — and many individuals who have experienced these types of adverse events lack the type of support, psychoeducation, and resources required for healing.

2. The neuroscience of brain development is critical to understanding developmental trauma — and ultimately is equally as critical to helping us to heal from it.

In “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma”, Dr. Bessel van der Kolk writes that “neuroscience research shows that the only way we can change the way we feel is by becoming aware of our inner experience and learning to befriend what is going on inside ourselves.”

Our brains develop from the bottom up: from the most basic levels of human functioning located in the brainstem to the more complex levels of skills centered in the cortex. A young child under 3 cannot create linear narrative memory — which requires utilization of the as-yet undeveloped cortex — but she can and does take in information experienced from the world around her in the lower parts of the brain.

And just like development happens from the bottom up, so too does our subsequent processing when we are older: for the rest of our lives, we process information taken in from our senses first through our brainstem, and subsequently through our diencephalon (which regulates arousal, sleep, appetite and movement), limbic system (where memory and emotion live), and finally our cortex: the thinking part of our brain, where speech and language lie. In other words, as Dr. Perry writes, “Our brain is organized to act and feel before we think.”

This understanding has huge implications for all of us. Our youngest years are incredibly formative, because our brains are developing the most during these first few years of life. Every set of experiences we have in this timeframe impacts our understanding of the world around us. A newborn baby utilizes their mom to regulate; they cannot yet regulate themselves, and so they learn these skills through the regulation they receive from their mother. Mom’s attunement to her baby’s cries and subsequent provision of nourishment or comfort is what ultimately helps the baby build her worldview: when I experience distress, I will be taken care of. The world is safe for me. This type of learning, experienced over and over and over again from an attuned parent, is what helps the child build internal resilience, learn self-regulation, and ultimately understand how to provide love and care to others.

These early years play a profound role in a child’s ability to one day grow up with the set of core tools needed to care for himself and others. Dr. Perry notes that if the core regulatory networks (CRNs) are disrupted in some way during that critical developmental period, higher parts of the brain — like the limbic system and cortex — are more likely to be adversely affected. The actions that build a healthy set of CRNs relate to how primary caregivers provide regulation to a child through nourishment, warmth, and touch. The healthy development of these CRNs is what ultimately leads to healthy development of our higher-level brain functions, which allows us to grow into adults with the capacity to regulate and relate to others.

Trauma in the early years of development literally changes the brain — and the earlier trauma occurs, the more impactful the events are to long-term functioning. Dr. Perry notes that “the basic finding is that the experiences of the first two months of life have a disproportionately important impact on your long-term health and development.” The studies he references looked at the difference that timing played in a child’s development and found that “if, in the first two months of life, a child experienced high adversity with minimal relational buffering but was then put into a healthier environment for the next twelve years, their outcomes were worse than the outcomes of children who had low adversity and healthy relational connection in the first two months but then spent the next twelve years with high adversity.”

This speaks to the critical importance of early intervention programs, and it also demonstrates the need for any adult in a child’s life (e.g. teachers) to deeply understand the child’s background and past experiences before diagnosing (or addressing) behavior. Children whose development was disrupted by traumatic experiences are likely to develop a sensitized stress-response system; in other words, they are likely to be more reactive to evocative cues that their lower brains perceive as threats due to past experiences. A child experiencing fear or anger is a child whose stress-responsive system has been activated. This activation means that the child is in a dysregulated state, and no amount of reason or logic will be able to reach them given that the cortex has gone “offline.” Instead, healthy therapeutic interventions need to focus on restoring balance first and foremost — in other words, regulation. Dr. Perry notes that “it’s best if you can simply be present…[that] you can’t talk someone out of feeling angry, sad, or frustrated, but you can be a sponge and absorb their emotional intensity.” He goes on to state that “if you stay regulated, ultimately they will “catch” your calm” and that “it helps to use some form of rhythmic regulating activity to keep yourself regulated while you’re doing this — like taking a walk, kicking a ball back and forth, shooting some baskets, [or] coloring side-by-side.”

This all points to the need for understanding state-dependent functioning: in other words, asking ourselves what state a person is in prior to determining the appropriate intervention.

3. Even though our early years are a critical period of development, we have the capacity to change over time — particularly if we understand how trauma is stored in our bodies.

We cannot change what we do not understand. So much of healing ourselves or supporting others through their healing is building a level of awareness of how our experiences have shaped us, including the ways that this trauma is stored in our bodies currently.

Those who work in education have likely seen many students in dysregulated states: in other words, students who have been triggered by something from past traumatic experience and whose body (brain and nervous system) is now reacting accordingly. Others who have themselves been impacted by developmental trauma might recognize their own dysregulated states, such as when our emotional reactions are relatively outsized compared to the precipitating event.

Understanding what happens in these moments is crucial to helping someone else — or ourselves — move to a fully regulated state. Most of us have heard of the concept of “fight, flight, or freeze” when it comes to our body’s response to perceived threat. The “fight or flight” responses correspond to sympathetic nervous system arousal. Conversely, the “freeze” response connects to the parasympathetic nervous system, but there’s an added layer of nuance that is critical to understand when thinking about how to work through trauma.

One of the key parts of our body to understand first is the vagus nerve, a nerve that connects our brainstem to many organs such as the heart, lungs, stomach, and intestines. The vagus nerve is part of the parasympathetic nervous system, which many might think of as the part of the nervous system that helps to calm our bodies. The Polyvagal Theory, introduced by Dr. Stephen Porges, provides a much more nuanced understanding of the vagus nerve’s two primary pathways: the dorsal vagus and the ventral vagus.

The freeze response relates to dorsal vagal shutdown. So if sympathetic nervous system arousal leads to “fight” or “flight” and dorsal vagal shutdown leads to “freeze”, what role does the ventral vagus play?

According to Polyvagal Theory, the ventral vagus is what is responsible for healthy, balanced, regulated functioning. If we think about the parasympathetic nervous system as the “calming” component of our nervous system, we can think of the dorsal vagus part as the body’s emergency stop button, working to protect us in moments of threat by shutting down the type of systems that could feel pain. This is, for example, typically what is happening when survivors of sexual assault describe being “outside of their body” during the attack; dorsal vagal shutdown is their body’s attempt to fully shut down cognitive (and other types of) function to provide some measure of life-saving protection.

The ventral vagus is the other side of calm: the healthy, regulated calm that means our systems are in balance. The “ventral vagal state” that Polyvagal Theory describes is the state of a balanced nervous system, where all components of our body are “on-line” and functioning.

When we have not recovered from trauma, we are often living in a constant state of dysregulation: meaning, our body is constantly experiencing either sympathetic nervous system arousal or parasympathetic (dorsal vagal) shutdown out of the misguided internal (subconscious) belief that “past is present”: that we are not currently safe. Part of helping our body get to safety is learning how to move ourselves to the ventral vagal state — in other words, learning how to recognize when we are in a state of parasympathetic collapse or sympathetic activation and understanding what techniques we can use to bring ourselves back into a state of balance.

Dr. van der Kolk writes that “the challenge of recovery is to reestablish ownership of your body and your mind — of yourself.” This level of brain/body connection is incredibly difficult for those who have experienced trauma in any form. The type of work required can be found in many interventions that often need to work in tandem with one another: in movement (such as yoga), in mindfulness (the ability to observe our sensations and thoughts), and in relation to others (through connection with a therapist, friends, and/or family members).

But this capacity to heal rests first and foremost on our willingness to look into the past with an eye toward understanding — and on the extent to which we are willing to learn how the body and the brain are connected.

Virginia Satir once wrote, “People prefer the certainty of misery to the misery of uncertainty.” Our ability to heal from trauma requires us to take the step toward uncertainty, and to be willing to sift through the misery in recognition that this work will eventually lead us to a healthier, happier state.

It’s incredibly hard work. But the beauty of this work is that we ultimately hold the power to change our experience, if we are willing to listen to what our brains — and bodies– are trying to tell us.