PsychRounds: The Psychiatry Podcast

Trauma and The Neurosequential Model of Therapeutics with Dr. Bruce Perry

Sep 10, 2025
In this engaging discussion, Dr. Bruce Perry, a leading child psychiatrist and co-author of acclaimed books on trauma, shares insights about his Neurosequential Model of Therapeutics. He breaks down the complexities of trauma, contrasting 'big T' and 'little T' experiences, and emphasizes how these affect child development. Dr. Perry also delves into the significance of emotional regulation, the impact of modern lifestyles on community connections, and the therapeutic power of rhythm. His holistic approach underscores the necessity of tailored treatments for recovery.
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INSIGHT

Trauma Is Defined By The Body's Response

  • Trauma depends on the internal activation of stress systems, not just the external event.
  • A neurobiological trauma is when the stress response changes set points or reactivity.
INSIGHT

Vulnerability Is Individual And Cumulative

  • Individuals vary widely in what stressors overwhelm them due to developmental and biological differences.
  • Repeated inadvertent exposures can wear down regulation and worsen outcomes over time.
ANECDOTE

Medical Code Example Of Differential Impact

  • Bruce Perry uses the example of first-year residents in a code to illustrate differing trauma responses.
  • Experienced clinicians stay regulated and may avoid lasting impact while novices can be more affected.
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