06/09/2026
Over the last few weeks, I have been reading "What Happened to You?" by Dr. Bruce Perry and Oprah Winfrey. Dr. Perry developed a theory called the Neurosequential Model of Therapeutics (NMT). In simple terms, the brain grows and learns to regulate from the bottom upwards in the photos below and in this order.
1) Brainstem: It is responsible for survival. Breathing, eating, and bowels.
2) Diencephalon: It is responsible for regulation.
3) Limbic System: It is responsible for emotions and development of relationships.
4) The Cortex: This controls a persons ability to reason, think, and problem solve.
When trauma occurs, especially in childhood, it disrupts the brain system. Many treatments start at the top by talking, teaching, reasoning, and analyzing. But that doesn't always work because the lower parts of the brain are still sounding the alarm. In other words, if your heart is pounding, your stomach is in knots, your muscles are tense, and you believe that you are in danger... It doesn't matter how logical advice is or how discipline or rules work in the school or at home because safety is the core need we all share. When someone is having a meltdown, lectures will not help. Consequences are not going to make sense. Logic isn't able to be used because the brain cannot connect the dots.
No safety = No clear thinking
Imagine your brain as a house. The basement is survival. The middle floor is your emotions and relationships. The upstairs is your logic and decision-making. If the basement is flooded, it doesn't matter how nice your upstairs furniture is. Before you can fix upstairs, you've got to deal with what's happening downstairs.
The same is true with adults. Most of us spend a lot of time focusing on upstairs.
"Why do I keep drinking?"
"Why am I ruining my relationships?"
"Why do I keep making these choices over and over again?"
We have to look at all parts of the home. The basement may have childhood trauma. It may have addiction, instability, stress, or violence, and neglect. Your home, or your nervous system, may have learned a long time ago that the world is not safe. Addiction is not always about getting high. Alcohol slows down the racing thoughts, pain pills can numb the emotional pain and m**h provides energy when depression has drained everything else. Gambling, food, po*******hy, shopping, or other behaviors provide escape from feelings that seem impossible to sit with. Those things become a bucket used to scoop water out of your flooded basement.
That bucket eventually creates it's own problems.
We cannot take away the bucket but not repair the flooding. That's why relationships, community, and therapy matters.
Dr. Perry uses an analogy of a reptile to explain this. A lizard isn't worried about next week's bills coming in late. Lizards wondering if people accept it's personality or it's beliefs. It isn't replaying conversations from ten years ago. A lizard operates under one question. That is, "Am I safe right now and are my needs met?"
That survival-focused part of the brain exists in all of us.
When children grow up in safe environments, their brains learn that the world is generally safe. But when stress or abuse is extreme, prolonged, or unpredictable, the brain learns to act differently to stay safe. It becomes really good at detecting danger. The problem is that years later, the danger could be gone but the alarm system is still goimg off.
What looks like anger, anxiety, impulsivity, emotional outbursts, withdrawal, or even addiction often makes much more sense when viewed through that lens. Children do not learn regulation by being told to calm down. They learn regulation from regulated adults. A child learns safety when someone comforts them and learns trust when someone consistently shows up.
Healthy relationships help build healthy brains.
This changed how I think about addiction and children.
Most people see the substance.
They see alcohol, m**hamphetamine, opioids, ma*****na, gambling, or other behaviors.
Many people aren't addicted because they love the substance. They're addicted because they become attached to what a substance does for them.
For someone carrying years of fear, loneliness, shame, grief, or trauma, the substance may provide the things that they have struggled to find elsewhere. Things like comfort, relief, calm, escape, and connection.
This does not excuse destructive behavior, but it does help explain it.
The question becomes less about substance use and more about the pain the person is trying to manage. We use lectures, arguments, and explanations to try to reason with someone dealing with this. And we fall short. Why?
Because the brain in this state cannot use logic. It cannot access the logic until the person feels safe and then connect.
We see addiction, anxiety, outbursts, shutdowns, or what people call "the problem". But those things are often the leaves on the tree. The roots are found in experiences, relationships, and the need to survive. The biggest lesson I took away from this book is that people's behavior often makes sense once we understand their story. Not to excuse it or avoid accountability, but replace our judgment with curiosity and understanding.
Instead of asking, "What's wrong with you?" ask the question, "What happened to you?"
This one question changes the way we see children, adults, addiction, trauma, and even ourselves.
This book is absolutely 12 out of 10 and will be in my top 5 recommended readings.
