The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist’s Notebook
Bruce D. Perry, Maia Szalavitz, 2006
A six-year-old boy lives in a cot that looks like a dog’s cage, and the doctors consider him hopeless. The child psychiatrist Bruce Perry tells the stories of his small patients and explains how harm changes the growing brain. And he shows what heals most powerfully: reliable people nearby.
Who it is for
For parents, teachers, foster families and everyone who needs to understand why a child behaves “badly” and what really helps them.
The capacity to love cannot be built in isolation.
A child behind the bars of a cot
In 1995 the child psychiatrist Bruce Perry was called to a children’s intensive care unit. The staff asked for help with a six-year-old boy named Justin: he threw food and his own excrement at people and would let no one near him. Perry saw him in a cot with iron bars, its top closed with a sheet of plywood. The child was living, in effect, in a dog’s cage. The doctors believed that Justin had severe brain damage and hoped for little. Perry wanted first to learn what had happened to this boy. We will come back to the answer near the end of the book.
For many years Perry has worked with children who have survived violence, neglect and disasters. Together with the science journalist Maia Szalavitz, he wrote a book from the stories of his small patients. Each story explains part of how harm changes the growing brain, and what helps it to recover.
For a long time it was believed that children are flexible: they will forget, they will outgrow it, they were even lucky to be small. Perry shows the opposite. The earlier the harm came, the deeper it can enter into how a person is built, because a child’s brain is still being constructed. But this thought has a second half, and the book is written for that half. The same growing brain can change, and it is changed most strongly by the people around it.
Ahead of you are seven stories. A girl absorbed the wrong lesson. A little girl saw the worst. Then come the children of a besieged community, a girl who did not grow and a teenager without compassion. Justin himself is the sixth, and the last is a boy from an orphanage whom his classmates helped. These stories are hard, but they are told for the sake of hope. Let us begin.
The brain learns what is repeated
Tina was seven years old when she was brought to Perry. The girl fought, could not concentrate in lessons, and behaved with other children and with adult men in a way a child should not. The cause was found: for two years she had been sexually abused by a teenage boy, the son of neighbours. The worst was already over, but the behaviour remained.
Perry understood that Tina was not spoiled and not “bad”. Her brain had learnt the lesson she had been taught: a man means danger, and danger can be softened if you behave in a certain way. The brain does not judge whether a lesson is good or bad. It fixes what is repeated.
Perry explains it this way. The brain is built from the bottom up, like a house from its foundation to its roof. First the brainstem matures, which controls breathing, heartbeat and body temperature. Above it lies the midbrain; higher still, the limbic system, linked with emotion and attachment; and last of all matures the cerebral cortex, where speech, thinking and self-control live. Each floor grows stronger according to how often it is used. Picture a path through the grass: the more often people walk along it, the more visible it becomes, and the easier it is for the feet to turn onto it by themselves.
Hence the conclusion Perry reached. One hour a week with a psychiatrist counts for little against the rest of the week. What Tina needed was not talk about safety, but safe encounters repeated many times: adult men beside her who behaved calmly, gently and predictably, again and again, until the new path grew wider than the old one.
For you this means a simple thing. No child or adult is remade by a single serious talk. What changes us is what happens every day: the tone at breakfast, the reaction to a mistake, a calm voice in a moment of fear. If you want to change something in your relationship with someone close, look not at important speeches but at the small things that repeat.
About the author
Bruce D. Perry is an American child psychiatrist and senior fellow of the ChildTrauma Academy in Houston, who for many years has worked with children who have survived violence, neglect and disasters. Maia Szalavitz is an American science journalist who writes about psychology and the brain.
All books by this author: Bruce D. Perry, Maia Szalavitz
Terms from the book
- Empathy
- limbic system
- dissociation
- Szalavitz: Maia Szalavitz, American science journalist and Perry’s co-author. She writes about psychology, the brain and addiction.
- brainstem: The oldest and deepest part of the brain. It controls breathing, heartbeat and body temperature, and it matures earlier than the other parts.
- cerebral cortex: The outer layer of the brain, which matures last. Speech, thinking, planning and self-control are linked with it.
- hyperarousal: One of the two reactions to threat in Perry’s model: the heart beats faster, the muscles tense, and the body gets ready to fight or run.
- Branch Davidians: A religious community led by David Koresh. Federal agents stormed its compound near Waco in 1993, and a siege followed.
- Waco: A city in the American state of Texas, near which the compound of the Branch Davidians stood.
- Koresh: David Koresh, leader of the Branch Davidians. He died in 1993, when the siege of the compound ended in a fire.
- Babylonians: What the children of Koresh’s community called people outside it, above all the authorities, whom the children were taught to regard as enemies.
- growth hormone: A substance the body produces, on which a child’s bodily growth depends.
- Mama Pi: What the book calls an experienced foster mother, to whom Laura was taken. She held children in her arms for long periods and rocked them.
- Arthur: The man with whom Justin stayed after his grandmother’s death. He bred dogs and, in Perry’s description, was not deliberately cruel but did not know how to handle a child.
- neurosequential model: Perry’s approach to helping children after trauma: help by the age of development rather than the age on the passport, and in the order in which the brain matures, from the lower parts to the higher. It is the author’s model from clinical practice.
All terms
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