The Boy Who Was Raised as a Dog

The most powerful therapy is human love

The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist's Notebook -- What Traumatized Children Can Teach Us About Loss, Love, and Healing - a review.

I came across this highly readable text while sitting in the Neurosequential Model of Therapeutics case‐based training series led by Dr. Bruce Perry and hosted by The ChildTrauma Academy. The aim is to aid practitioners better understand the neurodevelopmental principles involved in primary symptoms as seen in the children they serve.  

This has been an immensely valuable teaching when working with and examining long-term effects of trauma in children, adolescents, and adults as well as describing how traumatic events in childhood change the biology of the brain.

At the same time I was introduced to the book; The Boy Who Was Raised as a Dog by Perry and journalist Szalavitz….

Chapter 6, “The Boy Who Was Raised as a Dog” begins with…

I met Justin when he was 6 years old, in 1995. He was in the Pediatric Intensive Care Unit (PICU). I had been invited by the PICU staff to come and, using that-psychiatric voodoo-that-you-do-so-well, try to stop him from throwing feces and food at the staff. The PICU was almost always full and was typically busy 24/7.

Nurses, physicians, aides and families crowded the unit. The noise from medical machines, phones and conversations kept the large room filled with a non-stop buzz. There were always lights on, people were always moving around and, although each individual moved with purpose and each conversation was focused, the overall effect was chaos.

I walked unnoticed through the din to the nurses' station and studied the board to find the boy I'd been asked to see. Then, I heard him. A loud, odd shriek made me turn immediately to find a bony little child in a loose diaper sitting in a cage.

Justin's crib had iron bars and a plywood panel wired to the top of it. It looked like a dog cage, which I was about to discover was terribly ironic. The little boy rocked back and forth, whimpering a primitive self-soothing lullaby.

Perry and Szalavitz collaborate well in this meditation on what is known about brain function in deprivation and healing. Although he prescribes some medication to help his young patients, Perry's bedrock is listening well, recognizing cues, and relying on the power of trusting relationships.

This is a beautifully written, fascinating tail of experiences working with emotionally underdeveloped and traumatized children. Perry offers simple yet vivid illustrations of the stress response and the brain's mechanisms with facts and images that form in the mind without being too detailed or confusing.

What is immediately obvious and hugely endearing is the sensitivity and compassion by which the stories are told. As Perry paints detailed, gentle images of patients who have experienced violence, sexual abuse and/or neglect the reader gets a glimpse of hope always not too far away. We are invited to follow a journey to understanding how the developing child's brain works and we learn that to facilitate recovery, the loss of control and powerlessness felt by a child during a traumatic experience must be counteracted.

Recovery requires that the patient be 'in charge of key aspects of the therapeutic interaction.' He emphasizes that the brain of a traumatized child can be re-moulded with patterned, repetitive experiences in a safe environment. Most importantly, as such trauma involves the shattering of human connections, 'lasting, caring connections to others' are irreplaceable in healing; medications and therapy alone cannot do the job. 'Relationships are the agents of change and the most powerful therapy is human love,' Perry concludes."

It takes a courageous healer to take on these travails, and Perry is unusually well suited to the task. It is highly readable and informative about the workings of language, memory, trust, and choice, and ultimately optimistic-while critical of a society that exudes violence and ignores prevention.

This is a book demands for parents, educators, policymakers, courts, and therapists.