What Happened To You?: Conversations on Trauma, Resilience, and Healing

Content Warning: This section contains mentions and descriptions of self-harm

This chapter examines the relationship between one’s history and current physical and emotional state, especially in the context of trauma.

Perry explains the difference between inheritance and transmissibility. Genetic inheritance refers to the passing down of traits through one’s biology, specifically through the traits encoded in one’s DNA. Transmissibility, however, refers to the ability of a trait to be passed from one person to the other irrespective of biology. Language is an example of a transmissible trait: a child growing up in a Spanish-speaking household will learn Spanish, but if the same child had been raised in a Japanese-speaking household, he or she would have learned Japanese. The ability to learn language is genetically coded into the human species; however, the specific language one picks up is dependent on exposure to that language in childhood. Speaking Spanish is not an inherited trait; it is a transmissible one. Similarly, Perry discusses how numerous other aspects of the human experience are transmissible: “Humankind […] can take the accumulated, distilled experiences of previous generations and pass these inventions, beliefs, and skills to the next generation. This is sociocultural evolution” (130). This is seen as unique to the human species, and is a function of the cortex, the part of the brain capable of storing and managing such higher-order cognitive functioning and memory. Transmissibility further points to the malleability of the human brain, also seen in its characteristic of neuroplasticity as discussed earlier. This malleability allows young children to absorb, along with the language of their parents, their beliefs and values as well. Owing to this, Perry asserts the importance of being mindful of what children are being exposed to. By presenting them with enough diversity of thought, belief, and behavior, it may be possible to disrupt the genetic transition of bias to raise a generation of humane, compassionate, and empathetic people.

Just as transmissibility applies to language, values, beliefs, and bias, it can also extend to fear—a child may absorb their parent’s fear toward dogs, for example, by picking up on and internalizing the kind of stressed and fearful behavior the parent displays around the animal. Furthermore, there are also some aspects of human stress-response systems that are “heritable,” in that genetic mechanisms play a role in how one’s CRNs function. Some individuals have an inherently hardier system, while others are more primed toward sensitization. Perry also discusses the epigenetic aspect of fear. Epigenetics refers to the study of how behavior and environment can influence genetic functioning, and it is built on the fact that genes work like switches. While all neurotypical humans possess a set of genes, particular ones may be turned on or off depending on various factors influencing genetic history and environmental influences. For instance, all human beings carry the genetic possibility of developing diabetes; some are primed to develop it faster or easier, owing to the gene having been turned “on” for multiple generations, i.e., one’s parents and grandparents have already developed the condition in their lifetime. For someone whose diabetes gene is turned “off,” it does not mean that they will never develop the condition; environmental and lifestyle factors, such as overeating or increased stress, can cause the gene to turn “on.” Not only will the individual develop the condition, but they will pass on this increased predisposition to their offspring. Similarly, if generations of a family have experienced trauma, such as slavery or sexual abuse, epigenetic mechanisms can result in the activation of stress-response genes for future generations. Children born within these families are most likely primed for sensitization of their stress-response systems. However, the fact that one’s genes work like switches also means that epigenetic mechanisms are reversible—with enough nurturing interactions and change in the environment and surrounding challenges, these switches can be turned off, and one’s physiology can be restored to a state of balance.

Ideas of transmissibility and epigenetic inheritance both point to the importance of tracing the different experiences one has had within their lifetimes, as well as their histories and contexts across multiple generations, to better understand what has contributed to shaping an individual. Winfrey presents an example of how she managed to connect the dots with respect to a fear she experiences and an incident that may have shaped it. As an adult, she would find sleeping alone at night extremely stressful, constantly haunted by a feeling that she was not safe. After reading about a school shooting incident in the news one day, she realized where the fear may have stemmed from. The principal of the school refused to put chains on the school doors following the incident because he did not want to constantly remind his students of the traumatic incident and reinforce the idea that school was not a safe space. This reminded Winfrey of one night when she was young and sleeping next to her grandmother: She woke up to find her grandfather, who had dementia, standing over her grandmother and attempting to choke her. Following the incident, her grandmother began to place a chair under the door handle and cans across the door to alert herself if the event recurred. Winfrey internalized this fear, and her mind became conditioned to constantly be in a state of arousal at night, pointing to the transmissibility of trauma and fear. She uses the incident to stress the importance of insight into personal history and context in order to better deal with one’s instinctive reactions and stress and regain some control in the face of fear.

Winfrey and Perry discuss some potential problems that one ought to keep in mind while learning to connect history to one’s current emotional and physical health. Perry notes that developmental trauma can disrupt one’s ability to form and maintain relationships, especially when trauma or neglect happens in the context of caregiving relationships (135). This causes the alteration of neural networks involved in relationship formation and impacts all areas of one’s life, from school and employment to friendships and intimacy. Perry also stresses the importance of factoring in developmental adversity in physical problems. Unfortunately, many trauma-related health problems are “dismissed, missed, and misunderstood” (137). He gives the example of a girl named Tyra, a 16-year-old girl with diabetes who had been hospitalized because her blood sugar had suddenly shot up, rendering her unconscious. Doctors were stymied because the dosage of insulin they were administering seemed to keep varying in its impact—Tyra’s blood sugar continued to swing wildly throughout her hospitalization. Believing that Tyra was engaging in secret, self-destructive behavior, Perry was called in for a psychiatric consult. In conversation with her, Perry inadvertently discovered that Tyra had recently watched a friend’s death from a gunshot. An ambulance had eventually arrived to take her friend away, and the sound of sirens was triggering a stress response every time she heard them outside the hospital. The hormone adrenaline, which is released during distress and threat, mobilizes to store sugar reserves in the body in an attempt to assist fight-or-flight behaviors, leading to increased blood sugar. The constant stress-responses that Tyra was having whenever she heard the sirens were causing her blood sugar to vacillate wildly, thus rendering the insulin ineffective.

Tyra’s response to the sounds of the siren is reminiscent of Mike’s response to loud sounds or Samuel’s responses to the smell of Old Spice. It points to the sequential order in which the brain processes sensory input—first in the lower areas of the brain before it can be considered by higher-order cognitive processes in the cortex. If the sensory input is matched with any stored memory, owing to its inability to tell time, the lower brain reacts to the current experience as if it is the same as the previous one. In the case of a traumatic experience, a stress-response is activated, and the cortex shuts down. Therefore, it is impossible to reason with someone who is dysregulated—they are incapable of accessing logic and reason in this state. To communicate with someone, it is important to ensure that they are regulated and feel connected to the communicator before one can try to reason with them.