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“Many there be that have run out of their wits for women.” King James Translation of the Book of Ezra originally written about 460, B.C.
 “Poor Tom hath been scared out of his good wits.” William Shakespeare in King Lear, 1606
 “During the whole of this time Scrooge had acted like a man out of his wits. His heart and soul were in the scene, and with his former self.” Charles Dickens in A Christmas Carol, 1843
“The scope of one’s personality is defined by the magnitude of that problem which is capable of driving a person out of his wits.” Sigmund Freud in The Interpretation of Dreams, 1899
“The situation was quite out of their control. They had never seen animals behave like this before, and this sudden uprising of creatures whom they were used to thrashing and maltreating just as they chose, frightened them almost out of their wits.” George Orwell, in Animal Farm, 1945

There are many reasons why studying the brain is difficult. We have anecdotes about the aftermath of brain injury. I recall learning about Phineas Gage, a railroad worker with a gentle disposition until a tamping iron was blasted through his skull in an accident involving explosives. With Mr. Gage, who amazingly survived this experience, we learned that one’s personality can go from gentle and cooperative to belligerent and aggressive if enough on one’s brain gets smooshed by a tamping iron. But the idea that we could intentionally do anything like what happened to Phineas Gage in order to study the results is disgusting.  Any strategy that physically invades the brain even minimally is absurdly risky. So the invention of Functional Magnetic Resonance Imaging (fMRI) by a Bell Labs team led by Seiji Ogawa in 1990 we have a new tool for observing which brain structures are active and which are inactive, in real time, based only on blood flow and level of oxygenation. Today, this technology allows us to see where a stroke has occurred and guides any necessary efforts to staunch the leaking vessel. We’ve obviously long known that strong emotions leave us without our wits (our higher cognitive powers) but with fMRI, we can observe where this actually happens in the brain.

Dr. Bruce Perry, MD, PhD has used information from the growing field of neuroscience only made possible since the invention of fMRI technology to offer us an understanding of the neurological aftereffects of chronic childhood trauma and a framework for our efforts to remedy those aftereffects: The Neurosequential Model©. He has developed content for educators, caregivers, therapists, and coaches.

When we think of trauma, we tend to imagine violence like bombings, plane wrecks or physical abuse. We may even have experienced this kind of trauma. We may know what it is like to avoid the intersection where a car accident occurred. Many of us know veterans who are having real difficulty reassimilating at home after their military service-related experiences of trauma.

It is more difficult to understand that what constitutes real trauma in early infancy, even as early as in utero, can be so much less dramatic though equally devastating, to the developing brain. Even before delivery, the mother’s emotional state is communicated to the developing fetus via her placenta and the neurotransmitters serotonin, dopamine, and nor/epinephrine. The developing brain in utero can’t help but be affected when these critical chemicals appear excessively or in too small quantities. This is the nature of trauma to a developing brain: it gets “wired” in ways that may not fit easily in the world into which it is to be born. Once born, this new being now needs “attentive, attuned, present and responsive” or optimal caregiving. Briefly, if an infant is left to wail for too long when hungry, cold, bored or in pain, their little bodies and brains do not learn what it feels like to be comforted but come to expect their needs to go unmet by an uncaring world. This early lesson is not easily unlearned, as you might imagine.

The quotes above allude to a central concept in Dr. Perry’s approach to understanding what has happened to these hurting children; the ones who have such a hard time navigating even the most benign of life’s challenges like brushing their teeth or getting in the car. They are literally scared out of their wits. This perpetual (baseline) state of fear means that children have less of their “wits” to bring to problem solving, academic achievement, learning right from wrong, or remembering morning routines.

Dr. Perry uses different language to describe this situation. He describes a “Sensitized Stress Response” to explain why these children overreact to even minor annoyances. He points out that all of us are subject to the effects of stress in our environment, like heat, cold, noise, or crazy traffic but that, if we are lucky, our infancy and early childhood offered the type of caregiving experience that led to our resiliency and our ability to recover fairly quickly from those stressors and to return to a “regulated” state of being. He points out that those among us whose early life was not fortunate enough to enjoy such “optimal caregiving” come away with brains vulnerable to even mild stress and not able to return to regulation easily. These children wake up in a “baseline state” that is already alert to the possibility of prolonged discomfort or immediate danger and the slightest thing can escalate them in to an aggressive, defensive reaction or, alternatively, a deep withdrawal as means of self-protection.

AZAFAP offers Dr. Perry’s Neurosequential Model for Caregivers (NMC) as a 6-week, 12-hour, introduction to his approach to helping children recover from that early, less-than-optimal caregiving experience. It relies on the same brain capacity that moves the developing child through all change: neuroplasticity. Neuroplasticity is the same power harnessed when one recovers from a stroke. By putting a person through the type of experience originally responsible for the development of a skill, the brain finds new areas, those undamaged by the stroke, to newly encode the skills lost to the stroke damage. In the NMC, rhythms like those experienced in a safe infancy supply the key to returning to the child the capacity for resiliency and self-regulation: rocking, walking, riding in a car, singing, or dancing, for example. In addition to these regulating rhythms, Dr. Perry alerts us to the need to respect the caution these children have learned to use in any and all relationships and to “dose” our efforts at developing trust, even to be patient enough to allow the child to initiate contact rather that to expect them to easily accept our gestures of affection.


  1. Check out the AZAFAP Event Calendar at https://azafap.gnosishosting.net/Events/Calendar.
  2. Our Friday night Happy Hour and Tuesday afternoon Coffee Chat continue. Some find me and a single other participant; others find a conversation among 4 to 6 people. The topics range from the silly to what hobbies have us in their grip to what life has thrown in our path. If you ever find yourself wanting a bit of grown-up conversation, consider joining us (check your email for the unchanging link).
  3. Parent Mentor Partners: AZAFAP has trained volunteer parents as mentors who are ready to help support foster, kinship, and adoptive parents through one-to-one conversations. Interested? Fill out the form at https://www.azafap.org/family-support-services/
  4. The Caring for Caregivers project provides counseling sessions for those who do not have insurance to cover counseling services. Find the information and link at https://www.azafap.org/family-support-services/
  5. I encourage you to check out what Dr. Bruce Perry has to offer. Find his thoughts at https://www.pcaaz.org/wp-content/uploads/2019/07/B21-Insightful-Caregiving-Intimacy.pdf and at https://www.neurosequential.com.

Thanks for listening. Maintain yourself so you can be there reliably for others.