What Happened To You?

My take aways from the new book by Dr Bruce Perry titled What Happened to You. Together with Oprah Winfrey, Dr Perry uses a story based approach to help the reader understand how our brains develop and react to trauma.

Brent Stevenson

My mother recently passed on a book to me that she had just read titled What Happened To You? Conversations on Trauma, Resilience, and Healing by Dr Bruce Perry and Oprah Winfrey.  

Chatting with her about the book, I could tell that the conversational style really engaged her and the story-based explanations of the neuroscience helped her process the important information.  She had a particular interest in the topic because her brother, my uncle, Dr Bryan Kolb has been one of the leading minds in neuropsychology since its’ inception; Oprah and Dr Perry helped her understand herself and her brother’s lifetime of work.  I read it in two days.

I am currently writing my second book as a story-based journey into the role mental health plays in people’s chronic and resistant pain problems, so the explanations in What Happened To You just made so much sense to me as a physiotherapist.  I work with people that are coming to me to help them with their experience of a persistent physical pain or dysfunction, but most of the time as we unpack their issues, I find that there is a deep seeded history of adverse stress responses held in their bodies.  How your body deals with physical and mental traumas is very personal, but the two experiences are almost always intertwined which can be hard to explain to people that have become relatively dysregulated by stress.  Dr Perry does an excellent job of explaining some of the neuroscience to help people shift away from asking “what is wrong with you?” to “what happened to you?”

Perry explains with pictures and diagrams that our brains are hierarchically organized into four levels with increasing complexity and capabilities as you move upward.  The cortex being the center of our thinking, language and values, down to our brainstem that is responsible for basic survival regulation.

photo from ensembletherapy.com

Cortex: creativity, thinking, language, values, time, hope

Limbic: reward, memory, bonding, emotions

Diencephalon/MidBrain: arousal, sleep, appetite, movement

Brainstem: temperature, breathing, heartbeats

He discusses the structure and development of the brain in the context of how we as humans experience stressors in our lives and the tools that we use to regulate ourselves both as children and as adults.  As children and infants, the cortex of our brain is still developing, and we are largely reliant on the more basic, lower levels of our brain to process the world around us to aid in our survival.  As adults we have more access to our cortex to think and problem solve, but we still process life through our brain from the bottom up, which causes the events that happened to us early in our lives to disproportionately impact the lens that we see the world through.  

Dr Perry talks about the patterns of stress people experience and how they can lead to either tolerance or sensitization.  Predictable, moderate and controllable stressors help a person create resilience, while unpredictable, extreme and prolonged stressors can make a person very vulnerable.  As a physiotherapist, I become very tuned into a person’s nervous system as I chat with them, physically touch them, poke needles into their muscles and guide them through movements.  It becomes evident fairly quickly if a person has an overly sensitized nervous system that may be responsible for the persistent tension they feel in their body.  Stress and trauma can be physical and/or emotional in nature, they can come in the form of a car crash, childhood neglect, an overbearing boss, or a history of abuse and can all have similar dysregulating effects on a person’s nervous system.  

We are all a product of everything that we have been through up until this very moment and we all have developed certain triggers that can affect how we feel.  People that have experienced supportive, stable childhoods with moderate levels of stress throughout their lives have likely developed a certain level of resilience while others that may have experienced more extreme circumstances will likely have developed some adaptive coping patterns.  Triggers will tend to cause a person to either activate their fight or flight response or their dissociate and avoid response which both revert them to using the lower levels of their brain and can make them more reactive and reflexive.  Adaptive responses to life events genuinely effect a person’s nervous system that is the electrical wiring to everything in the body.  Imagine that your nervous system is an electrical grid that functions well with a certain number of amps running through it, now imagine how you would feel if I cranked up the power for a day, a week or a decade.

Physical and emotional traumas effect the number of amps running through your system both locally and globally.  Your brain deals with emotional stress by creating bracing holding patterns in different parts of your body, most commonly in the tissues around your organs and the muscles in your shoulders, neck and butt.  It is through this means that persistent emotional stress can create a physical pain or dysfunction in the absence of any actual tissue damage, inflammation or boney degeneration.  Your subconscious guarding patterns can cause a muscle to stay in a contracted state, which may limit blood flow, restrict the movement of a joint and set off a chain of compensatory movements and postures that eventually start to hurt.  I see it every day in my work as a physiotherapist.  I have techniques like IMS dry needling, visceral manipulation, mindful education and movement training that can help a person better regulate their nervous system and feel more comfortable in their body, but some people have so many triggers that their bodies seem to be living in a constant state of fear.  

Unfortunately, many people get caught in a viscous cycle of emotional stress creating physical pain until the physical pain itself becomes the more driving stressor in their day-to-day lives.  It is important to help people with the immediacy of their pain, by offering interventional treatment options to help regulate their nervous system and provide them with better access to their cortex (thinking, hope), followed by helping them to understand “what happened to them.”  This is the fundamental problem that medical systems do not allow for when trying to help people in pain and people don’t understand when they are trying to seek help.  Quite often doctors are not the best discipline to turn to if you need help, they are amazing at keeping you alive, but they typically don’t have the time, knowledge or skill to allow you to tell your story and support you in the way you actually need.  I encourage people to understand the scope of their doctors and selectively explore the expertise of allied health professionals like physios, counsellors, Pilates instructors and life coaches.

I highly recommend reading What Happened to You? as a means of better understanding both yourself and those around you.  Trauma is everywhere in our society and we will all collectively be better off if we have the capacity to be empathetic to those that seem to be having a bad day.  

I have just finished creating my online course on IMS Dry Needling to help healthcare professionals to expand their approach beyond simply treating trigger points to address pain.  Click here for more information.

I share many of my own personal stories in my first book Why Things Hurt: Life Lessons from an Injury Prone Physical Therapist.  Click Here for more information.

I am currently writing my second book full of stories on how our bodies actually work and will be looking for a publisher soon.

Click here for a full list of my blog articles

Click here to watch my video library explaining posture and exercise.

Please feel free to leave a comment below and I will try my best to respond.

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