Tag Archives: explicit memory


Dan Siegel on Explicit Memory

Dan Siegel hand model 3Dr. Daniel J. Siegel uses his “hand model” of the brain to show schools kids, and the rest of us, how we need all three of the brain’s main parts to be working, and to work together.  Say the wrist is the spinal cord.  Then the palm represents the reptilian brain stem, the thumb is the emotional limbic brain, and the fingers are the thinking frontal cortex. Video: www.youtube.com/watch?v=DD-lfP1FBFk

But last week, we said that neither the brain nor the mind can simply create memories like a video camera makes movies.  Instead, first we receive a flood of raw sensory data packets from the outside world which is scattered around the body, the nerves and the primitive reptilian brain stem.  And the primitive brain stem (palm of hand) doesn’t think — or have conscious memories.

For real permanent memory, which he calls “explicit memory,” Siegel says we need the hippocampus, which is up above the brain stem, in the limbic emotional lobe (thumb).  The hippocampus is responsible to A. integrate the raw sensory data into a coherent picture, and B. put a “time tag” on it – transfer it into long-term permanent memory, where it can be retrieved later.  That’s the only way to get it into conscious thought, which occurs in the frontal cortex, the highest cognitive part of the brain (the fingers in his model).

Explicit memory is what we usually “think” of as memory; it’s a “thinking memory” or “cognitive memory,” a memory we can remember in our thinking brain. It’s “the whole movie,” for which a caption of sorts has developed in the higher parts of the brain to say: ‘this is a dog, and it’s this particular dog right now” – as opposed to that dog you saw in 1994.

But there are (at least) four ways in which the hippocampus may not be available  –  which means, humans easily may not remember traumatic events, Siegel shows.

Four Ways to Turn Off Hippocampus

Scarecrow That's Me all overFirst off, from conception to 36 months, even in a 100% healthy child with secure attachment, the hippocampus isn’t working yet; doesn’t have enough myelin to fire, it’s just not online. Events which happen during this first 45 months of life just don’t automatically become conscious memories.  Siegel gives an example of a toddler bitten by a dog.  But this is also true for any memory function a toddler has, of all events pleasant or frightening, before the hippocampus is fully working around age 3.

“Let’s say I’m 6 months old and I’m bitten by a dog on the hand,” Siegel says. “And then I’m 2 and again I’m bitten by a dog on my hand. So I’m going to have a feeling of fear when I see dogs, I’m going to have a feeling of pain in my body,  I’ll have many memories, all implicit – feeling of fear, feeling of pain in my hand, visual what does a dog look like, barking sound what does a dog sound like – and the feeling that I want to get ready to run

“Implicit memory when it’s encoded and just stays in that pure form goes into storage where it’s just changes in my synaptic connections,” he says.  It’s purely a set of raw unconscious body memory packets.

Without a functioning hippocampus, the data sits scattered all over the body – like the straw Scarecrow in the Wizard of Oz.  “They tore my legs off and threw them over there,” he says. “ Then they took my chest out and threw it over there.”  “That’s you all over,” says the Tin Man.

So neither of these two incidents, the bite at six months or the bite at age 2, ever got integrated into a coherent conscious memory  – nor did they ever get a “time tag” put on them, a clear concept that the two incidents happened in 1992 and 1994, say.

What happens to this person as an adult 20 years later in 2014 when he sees a dog?  “Now today I hear a dog barking,” Siegel goes on, and my brain goes to retrieve whatever memory it has of “dog.”

“The retrieval of a memory is the firing of neural patterns that are similar to but not identical with, what was encoded at the initial time of the experience.

“But here’s the most important lesson about memory integration:  Implicit-only memory does not feel like it’s coming from the past.  When I hear a dog, I just feel fear, period.  I don’t say,  ‘Oh, I was bitten at six months, at two years… yeah, dogs can hurt you.’  No; I just feel scared – and I get ready to run [without thought.]  Maybe I focus on the fangs of a little puppy and I see a wolf – not just a little cute puppy.  Fear hijacks my perceptual system.” [ FN1]

Second, the hippocampus itself can be damaged during those 45 early developmental months (one reason it’s called “developmental trauma.”)  If an infant or toddler has repeatedly frightening experiences, such as hostile adults continuously in the home, the neurology of the primitive brain stem gets thrown off enough that it can harms the development of the higher brain lobes — which are outgrowths of the brain stem. The hippocampus can be badly damaged, to where when we feel scared irrationally, we physically can not “think our way out” just as Dr. Bessel van der Kolk told the New York Times.

This was me; I’d been told that I’d had infant trauma from conception to 36 months.  Listening to Siegel it hit me that talk therapy (and other cognitive work) regarding events and feelings during years no one can remember, had to be a waste of time. Siegel said the memories were lying around un-assembled in my body.

One of the next webinars I heard was his friend Dr. Peter A. Levine, talking about how to assemble these body memories, using “somatic experiencing.”  So I took Dr. Levine’s book “Healing Trauma” to my therapist and said: “Sorry you’re not familiar with somatic work, but I got traumatized before I was 3 and had a thinking brain, so the trauma’s baked down into my body parts, where talk and cognition can’t get at it.  This book is what we’re going to do.”  Our results were spectacular. [FN2]

Third, Siegel said that even if the hippocampus develops pretty well, trauma after 3 years of age and at any point in life, floods the body with so much stress hormones that  this can turn off the hippocampus. “If you massively secrete cortisol stress hormone, at the same time you’re secreting adrenaline, cortisol, in high amounts, shuts off the hippocampus temporarily.  Over the long run, it can actually kill hippocampus cells.

“But adrenaline increases the synaptic changes in implicit memory. So what we’ve just described, a useful vision for PTSD, is a model for explaining flashback of phenomena: when an implicit memory is reactivated without any explicit elements, the hippocampus hasn’t been involved to experience these things in awareness. So it’s not the same as unconscious memory or anything like that. These are elements encoded, stored and now retrieved into awareness, but when they’re implicit only, they have no tagging that they’re coming from the past.” [FN3]

Fourth, there are types of trauma where a person older than age 3 with a functional hippocampus can literally, during a traumatic event, dissociate themselves to avoid experiencing it when it’s happening  – so they can’t remember it later.  “You can divide attention,” says Siegel.  “If you’re being attacked you can focus on a beautiful beach, so you’ve taken your hippocampus out of the picture – but unfortunately you can not block the implicit coding [of the raw separate bodily memories of what was actually being done to you -kb]…

“If you were betrayed by your father or mother, if they abandoned you or hurt you or ignored you in terrible ways, it makes no sense that that would happen to you. So how do you make sense of something which doesn’t make any sense?,” says Siegel.  “It turns out that the part of our hippocampus which is the narrator is in the left hemisphere, but it has to draw on the hippocampus in the right hemisphere for storage of autobiographical data.

“Say your dad drank and he attacked you — so you dissociated and thought about the beach.

“So now [years later] the therapist asks you ‘What did that feel like, were you terrified of your parents?’   Your left narrator wants to cooperate, so it calls over to the right side and asks ‘Any feelings of fear of parents over there?’ and the right side answers back ‘Nothing over here, Dan, but sand and water.’  But your body also feels fear and you  may be sick to your stomach — none of it conscious.”   [FN4]


Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.


FN1   Siegel, Daniel J., MD, “Domains of Integration,” July 27, 2010 lecture audio  http://www.drdansiegel.com/uploads/DomainsofIntegration.mp3  To download, right click Play arrow, left click Save Audio As  [or go to http://www.drdansiegel.com/resources/audio_clips/  scroll down to title, right click to download]

FN2  Levine, Peter A., PhD, “Healing Trauma: A Pioneering Program for Restoring the Wisdom of Your Body,” ‘Sounds True, Inc.,’ Boulder CO, 2005; ISBN 1-159179-247-9

FN3   Siegel, Daniel J., MD, “How Mindfulness Can Change the Wiring of Our Brains, October 12, 2011 Webcast, National Institute for the Clinical Application of Behavioral Medicine (NICABM), http://www.nicabm.com/mindfulness-2011-new/

FN4   op cit  FN1  Siegel, “Domains of Integration”

Daniel J. Siegel, MD, is clinical professor of psychiatry at the UCLA School of Medicine on the faculty of the Center for Culture, Brain, and Development and founding co-director of the Mindful Awareness Research Center.  He is a Distinguished Fellow of the American Psychiatric Association and Executive Director of the Mindsight Institute. He is also Founding Editor for the Norton Professional Series on Interpersonal Neurobiology which contains over three dozen textbooks.

Must-read interview:
Siegel, Daniel J., MD, “Early childhood and the developing brain,” on “All in the Mind,” ABC Radio National, Radio Australia, June 24, 2006 at: www.abc.net.au/rn/allinthemind/stories/2006/1664985.htm

Books by Dan Siegel:
–”The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are,” (Guilford, 1999). How attachment in infancy and childhood creates the brain and the mind.
–”Healing Trauma: Attachment, Mind, Body, and Brain,” Marion F Solomon, Daniel J Siegel, editors,  New York, NY:  W.W. Norton and Company;  2003.   357pg  Reviewed by Hilary Le Page, MBBS at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553232/
–”The Mindful Brain: Reflection and Attunement in the Cultivation of Well-Being,” (Norton, 2007)
–”The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration,” (Norton, 2010)
–”Mindsight: The New Science of Personal Transformation,” (Bantam, 2010)
–”Parenting from the Inside Out: How a Deeper Self-Understanding Can Help You Raise Children Who Thrive,” (Tarcher/Penguin, 2003) with Mary Hartzell
–”The Whole-Brain Child: 12 Revolutionary Strategies to Nurture Your Child’s Developing Mind,” (Random House, 2011) with Tina Payne Bryson, Ph.D
–”Brainstorm: Power and Purpose of the Teenage Brain,”  (Tarcher, 2013)

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Allan Schore: What is the “Self”?

Allan Schore 2In March 2013, I was standing unknown in a crowd of professors and therapists at a UCLA conference, and noticed a quiet gentleman on my right.  I’d seen his photo online.  “Dr. Schore?” I asked.  “Yes,” said Allan Schore, turning calm eyes on me.

“I’m so grateful for all you’ve done to show that babies can’t control emotions, that’s the mother’s job to model, and emotions are ok,” I blurted,  suddenly in tears. “I’m writing a book on what it feels like on the inside, when we don’t get that as an infant.”

Dr. Schore didn’t flinch; his eyes grew wide with empathy. He got it.  He got a total stranger, right by the conference stage, got that I had walked through a hell of emotional pain to study this. He got that I was feeling love for him because he’s shown there’s a scientific reason for the pain.  He got that “emotions are ok” and only emotions from a caring other can heal this, so he gave me emotions: presence and compassion. On the spot. “We see it every day,” he said.

Just sayin’: he walks the walk.

UCLA professor Allan Schore is a world leader in Attachment Theory. He’s known as “the American Bowlby” after British psychiatrist John Bowlby who first wrote about attachment in the 1950s. [FN1]  Schore was among the first to put together the latest brain science on how an infant’s brain forms biologically (“developmental neuroscience”), with the early psychology of the infant mind (“developmental psychoanalysis”).

Dr. Schore’s 9-28-14 Oslo speech “The Most Important Years…the Right Brain and Its Importance” is a must-see to understand infant developmental trauma. He calls it  “trauma in the first 1000 days, conception to age two.”  Schore reviews how the theories he’s published since the 1990s are being proven to be hard science by today’s brain scan technologies (content starts minute 8): https://www.youtube.com/watch?v=KW-S4cyEFCc

Schore is known for documenting the “origin of the self”– what, scientifically, is the “Self”?  What is it that makes me, Me?

He calls it “the origin of the early forming subjective implicit self.” It’s entirely subjective; each infant has a different experience.  It’s “implicit memory” because the self forms in infancy when memory is only subconcious. It all happens years before we have thought and conscious “explicit memory” at age two or three.

This isn’t mere geek-speak; the mental, emotional, and physical health of all humans depends on it. We can’t remember what happened before age 3 when our self was formed, but the experience had massive impact. It’s all still “down there,” driving our feelings and behavior big time for the rest of our lives.

When the self is damaged during formation in early infant and childhood, a person can feel miserable all their life. The ACE Study shows this often leads to biological disease and premature death.

The Self and Emotions : Secure Attachment

brousblog4c Claire+MosesBabies are born with a massive level of emotions. Schore reports that they are  overwhelmingly dependent on the mother to show them how to handle it all. An infant’s brain doubles in size “from the last trimester of pregnancy through the second year,” he says. “At birth, there are hardly any cortical (conscious thinking brain) areas that are myelinated and online… so it’s impossible for the baby to regulate its own emotions…

The mother is the regulator of that baby,” he says, and this shapes the development of its entire brain. “Over the first year… the mother’s interactions are shaping the very wiring of those higher regulatory centers… Attachment communications which are emotional are forging the connections in the early developing right brain… The right brain literally is imprinted by these attachment relationships while it is being created…”  FN2

It’s all subconscious. With “secure attachment,” when a baby cries, the mother “attunes” to it. An “attuned” mother doesn’t say “think” or “ought to.”  She feels a strong, emotional urge to comfort her baby; she subconsciously intuits whether her baby cries because it’s hungry, wet, or tired. “The mother is able to pick up the baby’s communications,” Schore says. “She is not doing this by language, there is no thinking or language before age two.  She is picking up bodily-based nonverbal communications:  facial gestures, auditory tone of voice, and tactile expressions.  The attachment communication is more than between the mother and the infant’s minds; it’s between their bodies…

“She is psychobiologically attuning to the internal rhythms… of the baby’s autonomic nervous system and central system arousal…  It’s an attunement of mind and body. In doing so, she is regulating the baby’s rhythms and allowing the baby to create different emotional states that are associated with these different rhythms. This is not a matching of behavior; it is more of an intuitive matching of the internal rhythms of the baby.

“The baby is expressing these internal rhythms through the emotional communications it is sending back to the mother, in the prosody of the baby’s voice, or in the cry, or in the expression on the baby’s face, or in the gesture.  They are matching each other’s subjective state. Now, when two people match their subjective states, there is a sense of empathy, there is a sense of a bond; a sense that ‘someone’s body is exactly resonating with my body.’  When that occurs there is an amplification of arousal, and this amplification of arousal leads to things like joy states.”

Infants also have no sense of self.  Instead, Schore adds, there’s a “mother-baby continuum” for at least the first six months of life where the “dyad” (mother and child) often don’t know (and don’t care) where one person ends and the other begins.

We begin life as a sea of emotions, and then mom models for us again and again, that she can comfort our wild emotions. Unconsciously we pick up that skill. After we cry and mom comforts us for the millionth time, one day we feel our way to stop crying because we’ve “internalized” mom’s comfort. We subconsciously learn to manage emotions, to both enjoy good emotions, and also–very important–to tolerate and be able to fully feel negative emotions. Without fearing or repressing them.

This is also called “Emotional Object Constancy.”  Mom was an external object, but now we’ve taken her image inside us, so we feel loved and emotionally secure 24×7, even when we’re alone.

Our “self” begins when we first start to “regulate” our own emotions (“affect”) this way. When we realize we can feel our emotions and also modulate them, without screaming for someone else to do it for us? That’s when we first realize that we are not merely part of mom. We’ve got some independent “self.” “Essentially, one’s self-concept is focused around a positive sense of emotionality in the self,” says Schore.

Insecure Attachment and Trauma

Still Face Experiment 2Or not.

Back to how all babies are born with a massive level of emotions. We’re all supposed to receive all that attuning above, then we’re fine.

Or not.

What if we’re an “Or Not” baby?  What if we cry but no one comes?  Or what if someone comes, but they don’t have the neural equipment to attune, or they’re too distressed to attune?  “That baby learns that there is no comfort, that emotions are terrifying, and the world is a scary place,” Dr. Schore says. His colleague Dr. Ed Tronick shows this graphically in the “Still Face Experiment”– click for video.  [FN3]

That baby often does not develop much of a self.  To the extent no one showed it how to manage emotions, the day could not come when it could “regulate like mom.” It can’t regulate, so it can’t individuate.

That is really uncomfortable; it’s what’s behind the feeling that “I have a hole in me.”

All the above leave deep damage, even just passively.

Plus, on top of that: what if we cry, someone comes, and then there’s active aggression; we’re yelled at or physically maltreated?

A whole lot can and does go wrong for a baby. I call that a lot of Adverse Infant Experiences (AIE). “Aaiiee!” Double ouch.

Schore says this is the root of developmental trauma.  “In trauma there is an intense negative state about the sense of self,” he says, with “extremely high states and low states of arousal, an inability to internally regulate their state or to use other people to help them regulate their state and bring them into a sense of comfort.”

With insecure attachment, he says, “there are problems that the caregiver is having emotionally…  There is anxious insecure attachment, where the mother is preoccupied or unpredictable… There is also avoidant insecure attachment, where the mother is mostly cold…

“And there is ‘mind blindness,’ so to speak. There are some mothers who cannot read the tone of the baby… depressive mothers have problems reading facial expressions, especially the facial expressions and gestures of the baby. You see inter-generational transmission of these deficits…”

Schore first showed this scientifically in his three blockbuster books Affect Regulation and the Origin of the Self (1994), Affect Dysregulation and Disorders of the Self, and Affect Regulation and the Repair of the Self.  FN4

“Affect regulation” means we can freely feel our emotions without being emotionally blocked, we can enjoy our emotions–yet also be “on top”of our emotions, so they don’t feel overwhelming, painful or frightening.  If not, we suffer “affect dysregulation ” i.e., some level of painful emotional chaos.

We all know people who either can’t or won’t access their emotions, or others whose emotions go out of control to where they and those around them feel miserable.  Others  swing to both extremes, but never simply enjoy their emotions without freaking out or hurting people.

The good news is: there is repair, as Dr. Schore’s third book lays out in detail. At a support group, Al Anon meeting, therapist’s office, or with friends, repair means we find other humans to do exactly what Schore did for me on the floor of that conference: be present emotionally with another emotionally-attuned human being.

If we can sit for an hour and attune to another human willing to share our emotion state and help us learn to gradually shift and modulate it, we learn to “regulate.”  Brain scans now show that we can literally repair the neural circuits which remained painfully out of tune when we didn’t receive human attunement as kids.

It takes time, perseverance, courage, and real human beings like Allan Schore.  I’ve met them–they’re out there.  Find them.


Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.


FN1  Bowlby, John, “The Nature of a Child’s Tie to His Mother,” British Psychoanalytical Society, London, 1958; “Attachment and Loss,” New York, Basic Books, 1969

FN2  Schore, Allan N., PhD, “Affect Regulation and Mind- Brain-Body Healing of Trauma,”   National Institute for the Clinical Application of Behavioral Medicine (NICABM), June 15, 2011
Schore, Allan N., “The right brain implicit self lies at the core of psychoanalysis,” Psychoanalytic Dialogues  21:75–100, 2011 www.lifespanlearn.org/documents/2011Handouts/Schore/Schore%20Psych%20Dialogues%2011.pdf
Interview with Allan Schore – ‘the American Bowlby,’  by Roz Carroll, UK ;  The Psychotherapist, Autumn 2001, www.thinkbody.co.uk/papers/interview-with-allan-s.htm

FN3  Dr. Ed Tronick of the U Mass Boston’s Infant-Parent Mental Health Program did his first “Still Face Experiment” work in 1975; his 2007 video  has over 1.3 million hits.  First a mother and child play in a responsive, attuned way, so the baby learns to interact with the world. Then she suddenly stops attuning. Video at: www.youtube.com/watch?v=apzXGEbZht0&feature=youtu.be

FN4  Norton Textbook Series on Interpersonal Neurobiology:
Schore, Allan N., “The Science of the Art of Psychotherapy,” April 2012; 480 pages
Schore, Allan N., “Affect Regulation and the Origin of the Self,” Norton textbook May 2003; first edition 1994; 432 pages

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Perry: Rhythm Regulates the Brain

Perry another headshotDr. Bruce Perry, MD is taking his healing for trauma to Washington in a May 4 program for the National Council for Behavioral Health.

And the doc’s got rhythm.  In fact, he and other trauma experts are reporting revolutionary success with treatments using yoga, meditation, deep breathing, singing, dancing, drumming and more.

These principles are so fundamental to our brains they go back to the dawn of man; the Vedas were sung before 5,000 BC (likely with yoga and meditation.)  My book describes how yogic chant and meditation saved my life in 2010, before I ever read a word about brain science.

One California county is trying to cancel such programs, insisting on Cognitive Behavioral Therapy (CBT) which relies on the thinking brain.  But Perry and many experts say talk therapy alone can re-traumatize trauma survivors.

Perry says we need “patterned, repetitive, rhythmic somatosensory activity,” literally,  bodily sensing exercises. Developmental trauma happens in the body, where pre-conscious “implicit memory” was laid down in the primitive brain stem (survival brain) and viscera. Long before we had a thinking frontal cortex or “explicit memory” function. [FN1]

The list of repetitive, rhythmic regulations used for trauma by Dr. Perry, Dr. Bessel van der Kolk, Dr. Pat Ogden and others is remarkable. It includes singing, dancing, drumming, and most musical activities.  It also relies on meditation, yoga, Tai Chi, and Qi Gong, along with theater groups, walking, running, swinging, trampoline work, massage, equine grooming and other animal-assisted therapy…. even skateboarding. Click here for Perry’s web page on interventions.

“I am asked how hip hop and skateboarding can help a child with depression or ADHD,” reports Dr. Sarah MacArthur of the San Diego Center for Children. “Yet 70% of the children showed improvement in symptoms of depression, anxiety, and PTSD.” [FN2]

The Brain Stem Rules

Perry simpler 4 brain from web“The brain organizes from bottom to top, with the lower parts of the brain (brain stem/diencephalon aka “survival brain”) developing earliest, the cortical areas (thinking brain) much later,” Perry says. “The majority of brain organization takes place in the first four years.

“Because this is the time when the brain makes the majority of its “primary” associations… early developmental trauma and neglect have disproportionate influence on brain organization and later brain functioning… When a child has experienced chronic threats, the brain exists in a persisting state of fear… and the lower parts of the brain house maladaptive, influential, and terrifying pre-conscious memories… ”  [FN3]

“People with developmental trauma can start to feel so threatened that they get into a fight-flight alarm state, and the higher parts of the brain shut down,” says Perry. “First the stress chemicals shut down their frontal cortex (thinking brain).  Now they physically can not think. Ask them to think and you only make them more anxious.

“Next the emotional brain (limbic brain) shuts down. They have attachment trauma, so people per se seem threatening; they don’t get reward from emotional or relational interaction.

“The only part of the brain left functioning is the most primitive: the brain stem and diencephalon cerebellum. If you want a person to use relational reward, or cortical thought – first those lowest parts of the brain have got to be regulated,” Perry concludes.

We must regulate people, before we can possibly persuade them with a cognitive argument or compel them with an emotional affect.

“The only way to move from these super-high anxiety states, to calmer more cognitive states, is rhythm,” he says. “Patterned, repetitive rhythmic activity: walking, running, dancing, singing, repetitive meditative breathing – you use brain stem-related somatosensory networks which make your brain accessible to relational (limbic brain) reward and cortical thinking.

“Cognitive behavioral therapy (CBT) is great if you have a developed frontal cortex – but we’re talking about a five year old kid who’s so scared to death most of the time that it’s shut down his frontal cortex ’cause he just saw his mother get shot,” Perry told an audience of therapists. “You’re going to do 20 sessions of CBT and expect change? That’s a fantasy.”  [FN4]

6 R’s for Healing Trauma

Perry NMT Bar Chart from webDr. Perry does separate developmental “maps” of each person (left) using his “Neurosequential Model of Therapeutics” (NMT). Each individual is so unique that using NMT needs training;  this blog is meant only to point you toward it. For an overview of NMT, click here for Perry, B.D. and Hambrick, E. (2008), “Neurosequential Model of Therapeutics.  Click here for training in NMT and Somatosensory Regulation.

Trauma healing, says Perry, requires 6 R’s; it must be:
Relational (safe)
Relevant (developmentally-matched to the individual)
Repetitive (patterned)
Rewarding (pleasurable)
Rhythmic (resonant with neural patterns)
Respectful (of the child, family, and culture)

“To change any neural network in the brain, we need to provide patterned, repetitive input to reach poorly organized neural networks involved in the stress response. Any neural network that is activated in a repetitive way will change,” Perry explains.

“The rhythm of these experiences matter. The brain stem and diencephalon contain powerful associations to rhythmic somatosensory activity created in utero and reinforced in early in life. The brain makes associations between patterns of neural activity that co-occur.

“One of the most powerful sets of associations created in utero is the association between patterned repetitive rhythmic activity from maternal heart rate, and all the neural patterns of activity associated with not being hungry, not been thirsty, and feeling ‘safe’ (in the womb).

“Patterned, repetitive, rhythmic somatosensory activity… elicits a sensation of safety.  Rhythm is regulating.  All cultures have some form of patterned, repetitive rhythmic activity as part of their healing and mourning rituals — dancing, drumming, and swaying.

“EMDR and bilateral tapping are variations of this patterned, repetitive rhythmic, somatosensory activity… We believe that they are regulating in part because they are tapping into the deeply ingrained, powerful permeating associations created in utero.”  [FN5]

For each child, the NMT develops a unique, personalized “map” (see above) of what the specific neurological damage has been, how far development has come (or not), and where the child needs to go. Next it creates “a unique sequence of developmentally-appropriate interventions,” says Perry. “While many deficits may be present, the sequence in which these are addressed is important. The more the therapeutic process can replicate the normal sequential process of development, the more effective…

“The first step in therapeutic success is brain stem regulation… Start with the lowest undeveloped/ abnormally functioning set of problems and move sequentially up the brain as improvements are seen…

“An example of a repetitive intervention is positive, nurturing interactions with trustworthy peers, teachers, and caregiver… using patterned, repetitive somatosensory activities such as dance, music, movement, yoga,  drumming or therapeutic massage…  This is true especially for children whose persisting fear state is so overwhelming that they cannot improve via increased positive relationships, or even therapeutic relationships, until their brain stem is regulated by safe, predictable, repetitive sensory input.” [FN6]

Sound like your family doctor saying “Go calm down in the gym” ?  I thought so – until I tried it.  It works, big time.  My story is here: “Dr. Perry: Music Makes Your Case.”


Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.


FN1  Perry, Bruce D., MD,  “Born for Love: The Effects of Empathy on the Developing Brain,” Annual Interpersonal Neurobiology Conference “How People Change: Relationship & Neuroplasticity in Psychotherapy,” UCLA, Los Angeles, March 8, 2013 (unpublished).
Library of articles on interventions, trauma, brain development: https://childtrauma.org/cta-library/
Training in NMT Method and Somatosensory Regulation, Power of Rhythm — Individual and Site Training Certification Programs, DVD/streaming training, and online training: http://www.ctaproducts.org
Dr. Perry’s latest research and key slides: “Helping Children Recover from Trauma,” National Council LIVE, National Council on Behavioral Health, Sept. 5, 2013 at www.thenationalcouncil.org/events-and-training/webinars/webinar-archive/  (scroll down to Sept. 2013.)
Dr. Perry’s YouTube channel with educational videos in depth: https://www.youtube.com/channel/UCf4ZUgIXyxRcUNLuhimA5mA?feature=watch

FN2  MacArthur, Sarah,PhD., “Wellness Innovations Transform Children,” San Diego Center for Children, June 2013, http://www.centerforchildren.org/live-blog/87-wellness-innovations-transform-children/

FN3  Perry, B.D. and Hambrick, E. (2008), “The Neurosequential Model of Therapeutics (NMT),” Reclaiming Children and Youth, 17 (3) 38-43;  and
Dobson, C. & Perry, B.D. (2010), “The role of healthy relational interactions in buffering the impact of childhood trauma in “Working with Children to Heal Interpersonal Trauma: The Power of Play,” (E. Gil, Ed.), The Guilford Press, New York, pp. 26-43
Both at: http://childtrauma.org/nmt-model/references/

FN4  Perry, Bruce D., “Born for Love,” op. cit. FN1

FN5  MacKinnon, L. (2012), “Neurosequential Model of Therapeutics: Interview with Bruce Perry,” The Australian & New Zealand Journal of Family Therapy, 33:3 pp 210-218, http://childtrauma.org/cta-library/interventions/

FN6  Perry & Hambrick, op. cit. FN3

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