Following a 2-day workshop in the Fall of 2013 by Dr. Bruce Perry of the Child Trauma Academy on the Neurosequential Model of Therapeutics [NMT], Pomegranate Health Systems made a commitment to further training in 2014. This type of therapy involves mapping a child or adolescent’s brain when the child has experienced neglect, trauma or abuse.
Because the brain develops in sequence from birth, each person’s development progresses in a specific fashion. It starts with the brain stem- controlling the basic functions, moves up to the diencephalon, limbic system and cortex. If the stimuli- events of daily life- are highly irregular, extreme or disruptive, a developing brain will organize around that to lay down responses appropriate for those conditions. If lovely, richly varied, gently repetitive sensory stimulation like hugs, cuddles, praise, rocking, cooing, sung lullabies etc. form the basis of the early experience instead, the brain builds itself differently in preparation for the next stage. Not only billions of neurons are affected, but the brain’s chemical messengers such as serotonin, dopamine and norepinephrine. This can affect sleep, wakefulness, mood and much more.
If, by the time one is a teen and has experienced a significant degree of disruption in early life, it becomes necessary to address the teen’s neuro-development and neurobiology before therapeutic intervention can be more fully effective according to the NMT literature. For instance, we’ve all seen grown folks ‘act like 6 year olds’; similarly, significantly deprived or neglected children may show evidence of ‘being behind’ in other ways, or have difficulty forming normal attachments.
The NMT Model provides the neuroscience which underpins the therapeutic intervention by identifying strengths as well as primary problems based on the assessment. The initial assessment seeks to determine where the child is; what the developmental challenges are. This is followed by evaluating vulnerabilities and resilience factors as well as attachments. The functional review is multi-disciplinary. It evaluates neural systems and neuropsychiatric symptoms which are then mapped visually. This helps to identify where and how clinicians will work with the child or adolescent.
The recommendations phase points to the interventions which will help to move the teen upon a more normal developmental path. Positive experiences are initiated and repeated which help to develop resiliency. The child or adolescent can draw upon strengths to become more successful in future, stressful situations. This includes developing the skills in being able to form healthy relationships and attachments. If the early caregiving experience is absent or involves negative interaction, the child might later develop aggressive or anti-social tendencies. Being able to regulate one’s response and/or behaviors is an important developmental skill for adulthood. Lashing out, acting in-appropriately, or impulsively, displaying violence or social aggression can be markers of behavior problems which originated in one’s early development.
The structured environment of residential treatment is helpful for many teens whose lives have not had structure to it. Becoming aware of one’s behavior, triggers, and responses is part of the therapeutic intervention. Teens learn to value themselves and others and begin to model respect. Considering that billions of neurons compose the developing brain, this work should not be taken lightly.
Dr. Perry identified six core strengths all children need for emotional development. These include: 1. Attachment, 2. Self regulation, 3. Affiliation, 4. Awareness or atunement, 5. Tolerance, and 6. Respect.
For more information, visit http://childtrauma.org/
There’s also a great article, Reclaiming Children and Youth by Bruce D. Perry and Erin P. Hambrick at http://www.reclaiming.com
[photo credit: MRI brain scans of human brain development scans taken at 1 week, 3 months, 1 year, 2 years, 10 years. Coronal view T1W from National Institutes of Health.]