The last time I wrote a book review, was probably in the mid 1980s when I had to for school. So I don’t know how this will go, but it’s worth trying, because the book was great.
Some months ago, when I was still fostering, I was talking to a social worker about things, and she recommended I read Dr Bruce Perry’s work. A few weeks later I came home from work and a pile of books had been left at my front door. I’ve just finished The Boy Who Was Raised As A Dog, a series of case studies about different traumatised children Dr Perry has dealt with over the years.
Dr Perry is an American psychiatrist who has undertaken a lot of research in neuroscience specific to childhood trauma. He founded (I believe) the Child Trauma Academy in Texas, a not-for-profit organisation involved in clinical care of traumatised children, as well as research and health professional education on the issue.
The Boy Who Was Raised As A Dog reveals the stories of a small number of the children Dr Perry has helped. He outlines their traumatic experiences, how these experiences impacted on the childrens’ neurological development, from a physiological perspective and how this abnormal physiology can explain the behaviours displayed by each child, and then how and why he and his colleagues implemented treatment which helped (or in some cases, didn’t help) the children.
Throughout the book he discusses the development of the human brain, and how traumatic experiences can interrupt normal development leading to delayed, unusual and / or disordered behaviours.
For years I’ve argued with people that many children and young adults misbehave due, at least in part, to disadvantaged upbringings. But it’s not really disadvantage, which was an unsophisticated way of describing it. It’s exposure to traumatic experiences which affects our neuro-physiology, which in turn affects our psychology. Anyone living in socio-economic disadvantage has an increased risk of traumatic experiences by the very nature of such an existence. Poverty, overcrowding, exposure to mental illness and substance abuse, exposure to stressful situations such as financial hardship and hunger, domestic violence, and lack of stability, are all things which increase any child’s risk of exposure to traumatic experiences, and simultaneousy reduces their chances at access to decent support systems to compensate.
Dr Perry takes it a step further though, explaining that it depends when you are exposed, to what type of trauma or neglect, how often you are exposed and at which stages of your brain development throughout childhood, as to how a child may or may not be affected. For example, a newborn who is severely neglected from his first days of life will have very different brain development processes, than a toddler who had some time for healthy processes to occur prior to being neglected. He discusses two such cases – one young man who is severely dysfunctional (and has committed a double murder) after experiencing severe neglect throughout his infant years, and one young man who displays unusual but endearing behaviours after experiencing a healthy first year or so of life before being left for long periods of time during his older infant years.
There is, as you might expect, a story about a boy who is raised for around 5 years with an elderly man who worked as a dog breeder. When the elderly man inherited the care of this baby via some convoluted family connections, he kept the baby in a dog cage, with very little human interaction, through a lack of understanding rather than any desire to cause harm to the baby, who he wasn’t able to care for properly. There is also a chapter on the child survivors of the Waco Massacre, and how and why they were treated together in the first few weeks after their release from captivity by Dr Perry and his colleagues.
The eleven chapters each tell a different story, each very different and informative in varied, but inter-connected ways. Anyone who works with or has any kind of contact with children who have, or are at risk of having, traumatic experiences, would find the stories and explanations in this book as invaluable as I have.
At the same time as reading this book I undertook an online Psychology course and learned about the human brain, another informative experience. The way that the spinal column leads up to the brain stem, our most primitive brain area which we share with reptiles. This area of the brain is responsible for very basic processes such as maintaining temperature and blood pressure, breathing, digestion, etc.
With evolution, our brain developed further, with the limbic system which is involved in formation of memories and emotions. Then the “neocortex” developed, and is involved with more sophisticated things such as language, perception, awareness of others’ feelings, etc.
The way that these different areas develop through childhood means that the brain of a child is highly – far more than I ever imagined – sensitive to, and affected by, the experiences that occur during childhood. When in childhood the traumatic experience occurs, and how the child presents to the clinician, determines the treatment significantly. Dr Perry uses what he calls “neurosequential treatment”, whereby the child’s brain is literally “mapped”, and the areas of the brain which are underdeveloped (due to neglect) or shut-down (due to exposure to trauma) are identified, and then given appropriate attention to promote healing. This may be as simple as rocking an older child back and forth repeatedly in a loving way, as an infant experiences regularly with their mother in normal experience, if the child is found to have missed out on such nurturing during infancy. Or it could be teaching a teenager who is self harming – which I learned is a very effective way for some, to block out bad memories of abuse – ways to “zone out” which don’t involve self-harm.
It has evoked memories for me, of a boy I nursed almost fifteen years ago who when he was admitted to hospital at around age 6, was found to have been living in a pen with pigs. He was removed from the family and came to hospital whilst alternative care was arranged, which in the time I was involved, didn’t happen and he remained hospitalised for a prolonged period of time. He could not speak, did not know how to shower or dress himself, and had many very odd behaviours. But in the couple of months that I knew him, he improved significantly simply by having contact with familiar people. He learned to follow basic commands, and bonded with a number of the nurses caring for him. He would be close to 20 years old now, and I often wonder what became of him.
Since that time I’ve had a lot to do with many traumatised children, and I wish that years ago, I knew the few basic concepts that I have learned from my reading and studies in recent times. It was interesting to hear Dr Perry describe how little was understood in the 1990s, and how much research has occurred since then. Child psychology and psychiatry has advanced in leaps and bounds since then, and despite having so much more to learn, advances in the field have had a major impact on what help is now available for those children who are lucky enough to engage with professionals in the system. Unfortunately many children in need of such help never encounter it because they don’t access or remain engaged with the systems in which psychologists, psychiatrists and social workers work. The children with highest need also don’t tend to remain well engaged in schools, where teachers may have the appropriate training to make a difference.
Those of us lucky enough to lead stable, happy childhoods are far less likely to end up with psychological problems, than those exposed to misery, deprivation, fear, violence, etc. Dr Perry also talks about the role that genetics and other influences have, and is very clear about the fact that every individual is different. But the brain development processes that occur in each of us during childhood, are a dominant consideration. It makes complete sense intuitively, yet learning about the processes that occur during childhood trauma, and stories of children whose brain development has been disrupted, and then learning that there are often effective ways to treat the resulting symptoms for many children, was really enthralling and I recommend the book to anyone interested in childhood and / or social psychology.