The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook

by Bruce D. Perry

“trauma bond” is also known as Stockholm Syndrome: children who have been tortured into submission “love” their foster parents the way kidnapped newspaper heiress Patty Hearst “believed in” the cause of her Symbionese Liberation Army captors.

The problem with traumatic memories tends to be their intrusion into the present, not an inability to recall them.

For people whose memories don’t negatively affect them in the present, pressuring them to focus on them may actually do harm.

Believing that you cannot recover unless you remember the precise details of a past trauma can also become a self-fulfilling prophecy. It can keep you focused on the past rather than dealing with the present.

the development of higher, more complex brain regions relies on proper organization of the lower, simpler areas. I explained how deprivation could affect these regions and cause the wide variations in their son’s behavior.

“The key is to parent Peter where he is developmentally, not where he is chronologically,”

The more healthy relationships a child has, the more likely he will be to recover from trauma and thrive. Relationships are the agents of change and the most powerful therapy is human love.

Trauma and our responses to it cannot be understood outside the context of human relationships.

The most traumatic aspects of all disasters involve the shattering of human connections.

this is especially true for children. Being harmed by the people who are supposed to love you, being abandoned by them, being robbed of the one-on-one relationships that allow you to feel safe and valued and to become humane—these are profoundly destructive

recovery from trauma and neglect is also all about relationships—rebuilding trust, regaining confidence, returning to a sense of security and reconnecting to love.

What works to heal them is anything that increases the number and quality of a child’s relationships. What helps is consistent, patient, repetitive loving care.

The wonderful thing about our species is that we can learn; our memories and our technologies allow us to benefit from the experience of those who came before us. But at the same time those technologies, even the ones that are presumably meant to bring us together, are increasingly keeping us apart. The modern world has disrupted and in many cases abandoned the fundamental biological unit of human social life: the extended family. There has been so much emphasis on the breakdown of the nuclear family, but I believe that in many cases the extended family, whose dissolution has been much less discussed, is at least as important.

The truth is, you cannot love yourself unless you have been loved and are loved. The capacity to love cannot be built in isolation.

modern societies have abandoned many of the fundamental elements required for optimal human mental health.

The disconnect between what we need in order to be mentally healthy and what the modern world offers can also be seen in the constant unease felt by parents—about the Inter-net, the media, drugs, violent predators, pedophiles, economic inequality and above all, the values of our culture that shape our responses to these issues.

“How do we build community in a modern world?

How do we deal with the presence of all of those things and create a world that respects our biological needs, one that enhances our connections to others rather than ignores or disrupts them?”

Children need healthy touch.

Unfortunately, we’ve become so afraid of unhealthy touch that we may actually make it more likely by failing to meet the needs of children for healthy physical affection.

As we increase distrust of others by keeping children inside, by not allowing them to play spontaneously in their neighborhoods with their friends, by rigidly structuring their lives, we are also destroying the community bonds that keep all of us healthy.

in order to develop normally infants need the devoted attention of one or two primary, consistent caretakers, and those caretakers need the daily support of a loving community that recognizes and relieves the exhausting demands of new parenthood.

TO HELP CREATE a biologically respectful home environment, parents can also do simple things like setting boundaries on media and technology—for example, having regular family meals when all phones, televisions and computers are off.

model behaviors that emphasize the importance of relationships, empathy and kindness in their interactions with people,

A child’s brain needs more than words and lessons and organized activities: it needs love and friendship and the freedom to play and daydream.

too many young children are spending more and more of their lives in environments so structured and regimented that there is little time to build friendships and get the practice and repetition needed to support empathetic caring.

not all stress is bad, that children require challenges and risk as well as safety.

It is natural to want to protect our children, but we need to ask ourselves when the desire for risk-free childhoods has gone too far.

If they don’t have the chance to practice coping with small risks and dealing with the consequences of those choices, they won’t be well prepared for making larger and far more consequential decisions.

We need to allow children to try and fail. And when they do make the stupid, shortsighted decisions that come from inexperience, we need to let them suffer the results.

we also need to provide balance by not setting policies that will magnify one mistake, like drug use or fighting, into a life-derailing catastrophe. Unfortunately, this is exactly what our current “zero tolerance” policies—that expel children from school for just one rule violation—do.

The American Psychiatric Association estimates that the average child views some 16,000 simulated murders and 200,000 acts of violence on television alone by the time she turns eighteen,

Evolutionists had long emphasized “nature, red in tooth and claw,” but a view that focused on the competition of the fittest for survival missed one of the most fascinating and important characteristics of humans and quite a few other species: the propensity for altruism.

Unfortunately, that basic sense of fairness and goodwill toward others is under threat in a society like ours that increasingly enriches the richest and abandons the rest to the vagaries of global competition. More and more our media and our school systems emphasize material success and the importance of triumphing over others both athletically and in the classroom.

More and more, in an atmosphere of increased competitiveness, middle- and upper-class parents seem driven to greater and greater extremes to give their offspring whatever perceived “edge” they can find. This constant emphasis on competition drowns out the lessons of cooperation, empathy and altruism that are critical for human mental health and social cohesion.

Some of the most distressing of these have been school shootings. What I’ve found time and again in these cases is a winner-takes-all school culture, where bullying is pervasive and accepted and where the “losers” are not considered people who need understanding and support, but utterly deserving of their alienation and exclusion.

when you emphasize merciless competition at the expense of all else, in a culture that glorifies violence, an occasional violent uprising by those who feel left out is hardly surprising. I don’t believe we will be able to prevent these incidents unless we work much harder to ensure all students feel included in their school community.

When children start to misbehave our initial impulse to punish and deprive them often serves us poorly; we tend to see children who are whiny and demanding and aggressive as “spoiled” and “indulged,” rather than recognizing that these qualities usually arise from unmet needs and unexplored potential, not from having too much or feeling too good.

In order for a child to become kind, giving and empathetic, he needs to be treated that way. Punishment can’t create or model those qualities. Although we do need to set limits, if we want our children to behave well, we have to treat them well.

Traumatized children tend to have overactive stress responses and, as we’ve seen, these can make them aggressive, impulsive and needy. These children are difficult, they are easy to upset and hard to calm, they may overreact to the slightest novelty or change and they often don’t know how to think before they act. Before they can make any kind of lasting change at all in their behavior, they need to feel safe and loved.

Unfortunately, however, many of the treatment programs and other interventions aimed at them get it backwards: they take a punitive approach and hope to lure children into good behavior by restoring love and safety only if the children first start acting “better.” While such approaches may temporarily threaten children into doing what adults want, they can’t provide the long-term, internal motivation that will ultimately help them control themselves better and become more loving toward others.

Troubled children are in some kind of pain—and pain makes people irritable, anxious and aggressive.

Only patient, loving, consistent care works; there are no short-term miracle cures.

Just because a child is older does not mean a punitive approach is more appropriate or effective. Unfortunately, again, the system doesn’t tend to recognize this. It tends to provide “quick fixes,” and when those fail, then there are long punishments. We need programs and resources that acknowledge that punishment, dep...

concentrating children with aggressive or impulsive tendencies together is a bad idea, as they will tend to reflect and magnify this, rather than calming each other. Although research demonstrates the negative results of such grouping, we have unfortunately gotten into the habit of organizing therapy groups and residential programs in ways that concentrate such children.

The most rapid rate of growth takes place in utero, and from birth to age four the brain grows explosively. The brain of the four-year-old is 90 percent adult size!

This is a time of great opportunity for the developing child: safe, predictable, nurturing and repetitive experiences can help express a full range of genetic potentials. Unfortunately, however, it is also when the organizing brain is most vulnerable to the destructive impact of threat, neglect and trauma.