The Traumatic Stress Institute fosters the transformation of organizations and service systems to trauma-informed care (TIC) through the delivery of whole-system consultation, professional training, coaching, and research.

Dr. Bruce Perry, founder of the Child Trauma Academy (, has been a pioneer in the study and treatment of traumatized children. His Neurosequential Model of Therapeutics teaches us that human brains develop and change sequentially. The lower part, which concerns the body, the danger response, and emotional reactions, develops before the higher part which involves words and analytical thinking. Effective use of the higher brain centers depend on development of the lower parts. Yet, most of our treatment with traumatized kids involves verbal, cognitive tasks.

Furthermore, brains develop and change in a use-dependent way. If you use a part more, it gets stronger. If you don’t use it, it withers away. What fires together wires together. If we want to change a child’s lower brain, we have to get her to use it. If you are mostly talking to her, you are not changing the lower part of her brain. Healing through talking and changed thinking will only truly take hold after lower parts of the brain heal.

In the early years of brain formation, patterns are set into the lower brain which determines our assumptions and expectations of life. If a child is hurt by people in the early years, they expect people to hurt by them from then on. Many repetitions are needed to change these previously learned associations.

This new understanding of the brain and how it changes opens exciting new avenues of healing for all treatment. Especially in congregate care programs, we have a “captive audience” and we can use things like recreational time for planful brain building. At the same time, we create new, more positive expectations of relationships. We can even change our clinical work to include more physical activity to open the deeper parts of the brain for influence.

So what is the radical significance of all this for our work?

The children in residential have almost all been wounded early in life, during the formation of the lower, bodily, emotional and danger-response parts of their brains. We must change their expectations of other humans. We want to pair human contact with positive emotions and good results, and to undo that old pairing of human contact and pain.

How do we engage the lower part of the brain to change it? We involved the child in physical activities with movement and rhythm. These could include music, dance, drumming, rocking, swings, tossing a ball back and forth, planting a garden, massage. We pair these activities with positive interactions with other people. We make sure they are fun and engaging and done in connection with adults.
What are implications of this? We have always maintained that the daily life in the milieu and the relationships with the mental health workers are powerful forces for change. Now we can see even more clearly that having fun with the children in physically engaged, active ways is one of the most effective things we can do to change their brains. And now we can do this more planfully and with targeted goals.

We want our children to associate human contact with pleasure and help. We want them to experience that life can be a fun, positive rewarding experience. We want them to know that when difficult things happen, you can turn to others for help and use your own skills to surmount them.

It is true, then, that our main function in treatment should be to help each kid have a great day. (Idea courtesy of Martha Holden, CARE project, Cornell Residential Care Project). Because having a great day will establish new patterns and templates in their brains. Having fun with staff, repeated many many times, will begin to change their expectations of interactions with others.

Another implication is this. As we know, our kids are acutely perceptive about other people’s moods and emotions. This also reflects their earliest brain development. They had to develop this perceptivity to stay alive and anticipate the next dangerous event. So they will know if the adult is actually engaged with them, actually having fun and feeling positive and affectionate. If the adult is distant, sarcastic, punishing or distracted and texting on their phone this will not change the child’s brain. In fact, this will confirm and further strengthen the negative patterns that are already established. So, in order to be successful in our change process, we need to take good care of our staff, so that they feel energetic, hopeful and available.

Isn’t this amazing? It turns out that having a lot of playful, energetic, engaged fun with the kids is one of the best thing we could possibly do! Get out that Wii and play Dance, Dance Revolution, and make sure the staff dance too, and laugh a lot…. Do it again and again. And you will be changing brains.