Introduction to the NMT, Bruce D. Perry
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The ChildTrauma Academy
Introduction to the NMT
Integrang Principles of
Neurodevelopment into Clinical
Pracce
Introducon to the Neurosequenal Model of
Therapeucs (NMT
Theory of Change
Why do you do the things you do?
How do you think they will cause
change for the client – for your child?
2011
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
The Brain Maers
•
The human brain is the organ responsible for
everything we do. It allows us to love, laugh, walk,
talk, create or hate.
•
The brain ‐ one hundred billion nerve cells in a
complex net of connuous acvity ‐
allows us our
humanity
.
•
For each of us, our brain’s funconing is a reflecon
of our experiences.
NMT Core Principles
A. Brain Organizaon and Funcon
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
Abstract thought
Concrete Thought
Affiliation/reward
"Attachment"
Sexual Behavior
Emotional Reactivity
Cortex
Neocortex
Limbic
Limbic
Plasticity
Complexity
Motor Regulation
Diencephalon
Cerebellum
"Arousal"
Appetite/Satiety
Diencephalon
DA
Sleep
NE
SER
Blood Pressure
Heart Rate
Body Temperature
Brainstem
Brainstem
ANS - body
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
Materials may not be replicated, repurposed or
modified without permission
Bruce D Perry, MD, PhD © 2010
The ChildTrauma Academy
Introduction to the NMT
C
ORTICAL
M
ODULATION
“Out”
“In”
Mature
Developing/neglect
Cortex
Cortical
Cortex
Limbic
Limbic
Limbic
Multi-level
Processing
DE
DE
BS
BS
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
The Neuron
Synapses
Dendrites
NMT Core Principles
Axon
B. Neurodevelopment and Memory
Cell
Body
Myelin
Sheath
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
The Brain Develops
USE-DEPENDENT DEVELOPMENT
The human brain, with all of its complex
structure and funcon, does not just
“pop” into existence.
In the 9 months following concepon, 100
billion neurons and 10 trillion glial cells are
born. These cells organize, move, connect and
specialize to create the amazing and
funconing brain of the newborn.
The more a neural system is
“acvated,” the more that system
changes to
reflect
that paern of
acvaon
This is the basis for development,
memory and learning
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
Materials may not be replicated, repurposed or
modified without permission
Bruce D Perry, MD, PhD © 2010
The ChildTrauma Academy
Introduction to the NMT
Brain Growth vs. Body Growth
Sequenal Neurodevelopmen
•
The brain is undeveloped at birth
•
The brain organizes from the “boom” up ‐
brainstem to cortex and from the inside out
20
l
15
Body
•
Organizaon and funconal capacity of
neural systems is sequenal
10
•
Experiences do not have equal “valence”
throughout development
Brain
5
0
5
15
10
20
Age in Years
www.ChildTraumaAcademy.org
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
Associaon
What is Memory ?
•
The capacity to bring
elements
of an experience
from one moment in me to another.
•
The brain makes associaons between sensory
signals co‐occurring in any given moment in
me
•
This is the unique property of life forms.
•
There are many ways that life forms do this ‐
genes, immune system, nervous system
•
This capacity allows humans to learn, create
images of the future and survive.
•
Nervous ssue is
designed
to store
elements of experience.
•
This capacity can also make humans vulnerable
to false associaons ‐ creang fears of non‐
threatening objects.
www.ChildTraumaAcademy.org
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
Neuroarcheaology
•
The age at which an adverse event takes place
will influence the neurodevelopmental impact
and the resulng funconal consequences
•
Therefore, developmental history of adverse
experiences is crucial to understanding
current funconing
•
NMT includes a developmental review of
adverse experiences AND the buffering effects
of relaonal health
Creang First Memories
The first set of unique sensory smuli
shape neural “networks” which will
“encode” and store – in neurons – the
template for future sensory smuli
similar to this original sensory
experience
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
Materials may not be replicated, repurposed or
modified without permission
Bruce D Perry, MD, PhD © 2010
The ChildTrauma Academy
Introduction to the NMT
“Out”
“In”
New
experience
is “filtered”
through
past
experience
NMT Core Principles
C. Relaonal Neurobiology and Aachment
www.ChildTrauma.org
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
Relaonal Neurobiology
Foundaonal Neural Systems
The neural systems mediang the stress‐
response, reward, procreaon, reproducon,
social‐affiliaon and communicaon are all
are inter‐related ‐ indeed, they oen share
the very same fundamental neurotransmier
networks and brain regions
Human beings are social
creatures.
The neural systems which mediate social
interacon, communicaon, empathy and the
capacity to bond with others are all shaped by the
nature, quanty and ming of early life
relaonships.
www.ChildTrauma.org
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
VTA
DA
Sensation of
pleasure and
safety
Release of
hormones
and “calmer”
regulation of
key stress
related
neural
systems
Somatosensory
cues
Primary
caregiver
Decrease
physiological
distress
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
Materials may not be replicated, repurposed or
modified without permission
Bruce D Perry, MD, PhD © 2010
The ChildTrauma Academy
Introduction to the NMT
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
LC
NE
Fear and
confusion
Activation of
key stress
related
neural
systems
Somatosensory
cues
Primary
caregiver
Increase
physiological
distress
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
All rights reserved © 2010 Bruce D. Perry
Materials may not be replicated, repurposed or
modified without permission
Bruce D Perry, MD, PhD © 2010
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