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Wednesday, 27 January 2021
The Boy Who Was Raised As a Dog Print
It’s not often that a book is published on the neurobiology of trauma. It’s even less often that I would read one, be completely riveted by it, and then want to discuss it with everyone I meet. But Bruce Perry’s newly released book, The Boy Who Was Raised As a Dog, meets all of those criteria and more, making it a must-read for parents, professionals and anyone who works with children.

Many of us grew up hearing the adage, “Children are resilient.” At last, Perry puts this myth to rest, saying, “Children are more vulnerable to trauma than adults.” (p. 38.) As parents many of us are told that our children cannot have trauma issues because they were adopted at young ages. Yet Perry dispels this, saying “The earlier [the trauma] starts, the more difficult it is to treat and the greater the damage is likely to be.” (p. 152.) Because of the immense change and malleability of the young brain, children are “rapidly and easily transformed by trauma.” And he has learned, as have many adoptive parents, that “though its effects may not always be visible to the untrained eye, when you know what trauma can do to children, sadly, you begin to see its aftermath everywhere.” (p. 39.)

With a combination of sad, but fascinating case studies, Perry shows the reader what happens to a child’s brain when the child undergoes trauma in the first few months or years of life. Although his stories are pictures of horrific abuse & neglect, it is easy to apply the understanding of how children who’ve experienced the early loss and separation inherent with adoption--and especially those who may have been neglected, however unintentionally, due to low ratios of caregivers in institutional settings—may experience some of the same problems. Dissociation, behavioral outbursts, sleep problems and hyperactivity are addressed. He writes, “In a classroom setting, unfortunately, both dissociation and hyper-arousal responses look remarkably like attention deficit disorder, hyperactivity or oppositional-defiant disorder. Dissociated children quite obviously are not paying attention: they seem to be daydreaming or “spacing out,” rather than focusing on schoolwork, and indeed they have tuned out the world around them. Hyper-aroused youth can look hyperactive or inattentive because what they are attending to is the teacher’s tone of voice or the other children’s body language, not the content of their lessons. The aggression and impulsivity that the fight or flight response provokes can also appear as defiance or opposition… While not all ADD, hyperactivity and oppositional-defiant disorder are trauma-related, it is likely that the symptoms that lead to these diagnoses are trauma-related more often than anyone has begun to suspect.” (p. 51)

But the exciting threads are those in which Perry describes his model designed to help children of trauma, called the “Neurosequential approach.” Perry understands what many parents of traumatized children have learned through trial and error, that “these children need patterned, repetitive experiences appropriate to their developmental needs, needs that reflect the age at which they’d missed important stimuli or had been traumatized, not their current chronological age.” He describes an amazing foster mother, “Mama P,” who instinctively knew to hold, rock and cuddle a seven-year-old, “providing the touch and rhythm that he’d missed as an infant, experience necessary for proper brain growth. A foundational principle of brain development is that neural systems organize and become functional in a sequential manner. Furthermore, the organization of a less mature region depends, in part, upon incoming signals from lower, more mature regions. If one system doesn’t get what it needs when it needs it, those that rely upon it may not function well either, even if the stimuli that the later developing system needs are being provided appropriately. The key to healthy development is getting the right experiences in the right amounts at the right time.” Perry’s neurosequential model focuses on treating the part of the brain at the level in which the child was “affected by neglect and trauma.” In this fashion, each brain level is addressed sequentially until the child reaches the point “where his biological age and his developmental age” match. (p. 139)

Oftentimes this means that parents must address the needs of a single child from many developmental levels. In talking to one family of a seven-year-old, adopted at three, Perry says, “The challenge is that, in one moment, you will need to have expectations and provide experiences that are appropriate for a five-year-old, for example, when you are teaching him a specific cognitive concept. Ten minutes later, however, the expectation and challenges will have to match those for a younger child, for example, when you are trying to teach him to interact socially. He is, developmentally, a moving target. This is why parenting these children is such a frustrating experience. One moment you are doing the correct thing and the next, you are out of sync.” (p. 223.)

Although the book is a must-read, two regrettable pieces were included. One is a description of an antiquated form of “holding therapy” that is more appropriately termed “rage reduction therapy.” Perry condemns the technique, yet he speaks of the marvelous work of the foster mother, “Mama P,” who instinctually knows to hold her children because they are “her babies.” The descriptions of the way that Mama P pulls her children close, helping them to become regulated in her calm presence, sounds like the type of holding that many of us would include under the umbrella of the term “holding therapy.” It’s unfortunate that assumptions are made that “holding therapy” is all bad, placing all types of holding under one broadly condemned category of therapy. A second regret is the designation of an entire chapter to a case where an adoptive mother with Munchausen’s by proxy syndrome (in which someone tries to make a child sick to bring attention to herself) attempts to make professionals believe her child has reactive attachment disorder. Munchausen by proxy is rare and it’s unfortunate that more doubt has been cast on the immensely hard job of parents of children with RAD through this story.

Yet despite the two reservations, this book is a powerful, informative, and immensely interesting read on the effects of trauma on the young, developing brain. It truly is a must-read for parents, professionals, and anyone who works with children.

Thank you, Dr. Perry, for helping us to help our children!

For information and materials regarding Dr. Perry's Neurosequential model, please visit his website.

Gotta get the book.
Written by Sherril Johnson on 2007-04-09 02:15:10
Makes me want to foster babies. Maybe I wil. 
S. Johnson 
SW Georgia

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