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The boy who was raised as a dog by Bruce D. Perry and Maia Szalavitz – Brief Remarks

Posted by Raul Barral Tamayo en Jueves, 1 de diciembre, 2016


Copyright © 2006 by Bruce D. Perry and Maia Szalavitz.

What happens when a young brain is traumatized? How does terror, abuse, or disaster affect a child’s mind–and how can that mind recover? Child psychiatrist Bruce Perry has helped children faced with unimaginable horror: genocide survivors, murder witnesses, kidnapped teenagers, and victims of family violence.

In The Boy Who Was Raised as a Dog, he tells their stories of trauma and transformation through the lens of science, revealing the brain’s astonishing capacity for healing. Deftly combining unforgettable case histories with his own compassionate, insightful strategies for rehabilitation, Perry explains what exactly happens to the brain when a child is exposed to extreme stress-and reveals the unexpected measures that can be taken to ease a child’s pain and help him grow into a healthy adult.

Through the stories of children who recover-physically, mentally, and emotionally-from the most devastating circumstances, Perry shows how simple things like surroundings, affection, language, and touch can deeply impact the developing brain, for better or for worse. In this deeply informed and moving book, Bruce Perry dramatically demonstrates that only when we understand the science of the mind can we hope to heal the spirit of even the most wounded child.

Bruce D. Perry, M.D., Ph.D., is an internationally recognized authority on children in crisis. Dr. Perry is the Provincial Medical Director in Children’s Mental Health for the Alberta Mental Health Board. In addition, he is the Senior Fellow of the ChildTrauma Academy (www.ChildTrauma.org), a Houston-based organization dedicated to research and education on child maltreatment. Dr. Perry has been consulted on many high-profile incidents involving traumatized children, including the Columbine, Colorado school shootings, the Oklahoma City bombing, and the Branch Davidian siege. He lives in Houston, Texas and Alberta, Canada.

Maia Szalavitz is an award-winning journalist who specializes in science and health. She is the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids and Recovery Options: The Complete Guide with Joseph Volpicelli, M.D., Ph.D. She lives in New York City.

Comments extracted from the book, they could be right or wrong, you decide for yourself:

  • The stories in this book are all true. The sad reality is that these stories are but a tiny percentage of the many we could have told.
  • Children were believe to be naturally “resilient”, with an innate ability to “bounce back”.
  • Vast majority of my patients had lives filled with chaos, neglect and/or violence. They’d suffered trauma that would have had most psychiatrists considering the diagnosis of post-traumatic stress disorder (PTSD), had they been adults with psychiatric problems.
  • We recognize that catastrophic events can leave indelible marks on the mind. We know now that the impact is actually far greater on children than it is on adults.
  • It is the rare child who escapes trauma entirely. By conservative estimates, about 40% of American children will have at least one potentially traumatizing experience by age eighteen: this includes the death of a parent or sibling, ongoin physical abuse and/or neglect, sexual abuse, or the experience of a serious accident, natural disaster or domestic violence or other violent crime.
  • I do not mean to imply that all of these children will be severely “damaged” by theses experiences. Roughly one third of children who are abused will have some clear psychological problems as a result.
  • You’ll meet some of the children who taught me the most important lessons abotu how trauma affects young people. And you’ll learn what they need form us if they are to build healthy lives. You’ll see how traumatic experience marks children, how it affects their personalities and their capacity for physical and emotional growth. For the most part the stories you’ll read here are success stories.
  • Ultimately, what determines how children survive trauma, physically, emotionally, or psychologically, is wether the people around t hem stand by them with love, support and encouragement. We can both create and destroy, nurture and terrorize, traumatize and heal each other.
  • Not all humans are humane. A human being has to learn how to become humane.
  • The stories here explore the conditions necessary for the develpopment of empathy. They reveal how children’s brains grow and are molded by the people around them.
  • I do not believe in “the abuse excuse” for violent or hurtful behaviour, but I have found that there are complex interactions beginning in early childhood that affect our ability to envision choices and that may later limit our ability to make the best decisions.
  • In order to understand trauma we need to understand memory.
  • In order to appreciate how children heal we need to understand how they learn to love, how they cope with challenge, how stress affects them.
  • A sincere, kind act, it seemed to me, could have more therapeutic impact than any artificial, emotionally regulated stance that so often characterizes “therapy”.
  • One of the most important characteristics of both memory, neural tissue and of development, then, is that they all change with patterned, repetitive activity. So, the systems in your brain that ger repeatedly activated will change and the systems in your brain that don’t get activated won’t change.
  • In some cases the brain systems associated with the stress response had become so active that they eventually “burnt out” and lost their ability to regulate the other functions they would normally mediate. As a result the brain’s capacity to regulate mood, social itneractions and abstract cognition was also compromised.
  • The developing brain is most malleable and most sensitive to experience (both good and bad) early in life.
  • Children become resilitne as a result of the patterns of stress and of nurturing that they experience early on life.
  • When the brain becomes sensitized, even small stressors can provoke large responses. Tolerance mutes one’s response to an experience over time.
  • To create an effective “memory” and increase strenght, experience has to be patterned and repetitive.
  • Stress is not always bad.
  • Emotions are powerful markers of context.
  • The brain is always comparing current incoming patterns with previously stored templates and associations. As the information moves upward from this first stage of processing, the brain has opportunities to take a second look at the data for more complex consideration and integration.
  • For infants and young children, incapable of or ineffective at fighting or fleeing, a dissociative response to extreme stressors is common. It is also more common in females than males and, if prolonged, dissociation is connected with increased odds for post-traumatic stress symptons.
  • We have come to understand that many post-traumatic psychiatric symptons, in fact, are related to either dissociative or hyper-arousal responses to memories of the trauma. These responses can help people survive inmediate trauma, but if they presist, they can cause serious problems in other areas of life down the road.
  • The animals that don’t have control over the shock often develop ulcers, lose weight and have compromised immune systems that actually make them more susceptible to disease. Sadly, even when the situation is changed so that they can control the shock, animals that haven been placed in a situation without control for long enought become too frightened to explore the cage to figure out how to help themselves. The same kind of demoralization and resignation can often be seen in humans who become depressed, and research increasingly links the risk of depression to t he number of uncontrollable stressful events people experience during their childhood.
  • PTSD is frequently accompanied by depression.
  • To restore its equilibrium, the brain tries to quiet our sensitized, trauma-related memories by pushing us to have repetitive, small “doses” of recall.
  • The more intense and overwhelming the experience, the harder it becomes to “desensitize” all of the trauma-related memories.
  • The responses of traumatized children are often misinterpreted.
  • It was a safe bet then that being so close to an overwhelming experience, this little girl’s heart would still be racing.
  • At any age, when people are faced with a frightening situation their brains begin to shut down their highest cortical regions first. We lose the capacity to plan, or to feel hunger, because neither are of any use to our immediate survival. Often we lose the ability to “think” or even speak during an acute threat. We just react. And with prolonged fear there can be chronic or near-permanent changes in the brain. The brain alterations that result from lingering terror, especially early in life, may cause an enduring shift to a more impulsive, more aggresive, less thoughtful and less compassionate way of responding to the world.
  • I safe, familiar and capable caregivers were available to children, they tended to recover more easily, often showing no enduring negative effects of the traumatic event.
  • To calm a frightened child, you must first calm yourself.
  • Post-traumatic stress disorder is not signaled by a constellation of new symptoms that develop long after a stressful event but is, in many regards, the maladaptive persistence of t he once adaptive responses that began as coping mechanism in response to the event itself.
  • Some of the most therapeutic experiences do not take plae in “therapy”, but in naturally ocurring healthy relationships.
  • The research on the most effectiv e treatments to help child trauma victims might be accurately summed up this way: what works best is anything that increases the quality and number of relationships in the child’s life.
  • People, not programs change people.
  • The brain is an historical organ. It stores our personal narrative. Our life experiences shape who be become by creating our brain’s catalog of template memories, which guide our behaviour, sometimes in ways we can consciously recognize, more often via processes beyond our awareness.
  • The most powerful pain we experience is the loss of attention, approval and affection.
  • “They are all my babies. It’s just that Robert has been a baby for seven years”.
  • She knew that you don’t interact with these children based on their age, but based on what they need, what they may have missed during “sensitive periods” of development.
  • Virginia and Laura demonstrated one way that neglect in early childhood can disrupt the development of the areas in the brain that control empathy and the ability to engage in healthy relationships., a loss that often leaves people awkward, lonely and socially inept. Emotional deprivation in the first years of life, however, can also predispose people to malice or misanthropy.
  • In order to function socially people need to develop what is known as a “theory of mind”. They need to know that other people are distinct from them, have different knowledge about the world and have different desires and interests.
  • The brain is an historical organ, a reflection of our personal histories.
  • Our genetic gifts will only manifest themselves if we get the proper types of developmental experience, appropriately timed. Early in life these experiences are controlled primarily by the adults around us.
  • The earlier it starts, the more difficult it is to treat and the greater the damage is likely to be.
  • To recover they must feel safe and in control. The last thing you want to do is force treatment on these children or use any kind of coercive tactics.
  • America had discovered an epidemic of child abuse, much of which was real and deserved genuine exposure and attention.
  • Early deprivation of love and affection can make some children manipulative and lacking in empathy.
  • The problem with traumatic memories tends to be their intrusion into the present, not an inability to recall them. When they intrude, discussing them and understanding how they may unconsciously influence our behaviour can be extraordinarily helpful.
  • Humans are social animals, highly susceptible to emotional contagion.
  • Many “cutters” have a history of trauma. When they mutilate themselves, they can induce a dissociative state, similar to the adaptive response they’d had during the original trauma.
  • In dissociative states people can become so disconnected from re ality that they move into a dreamlike consciousness where nothing seems real they feel little emotional of physical pain.
  • The more healthy relationships a child has, the more likely he will be to recover from trauma and thrive.
  • Relationshops are the agents of change and the most powerful therapy is human love.
  • Medications can help relieve symptoms and talking to a therapist can be incredibly useful. But healing and recovery are impossible without lasting, caring connections to others.
  • For countless generations humans lived in small groups, made up of 40 to 150 people, most of whom were closely related to each other and lived communally. By 1850 that number was down to ten living in close proximity, and in 1960 the number was just five. In the year 2000 the average size of a household was less than four, and a shocking 26% of Americans live alone.
  • You cannot love yourself unless you have been loved and are loved. The capacity to love cannot be built in isolation.
  • 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. This can make them more vulnerable to pedophiles, not less, as children will tend to seek out those who appear affectionate toward them.
  • When humans evolved, infants didn’t have their own room, they didn’t even have their own bed. They were usually never more than a f ew feet away from an adult or sibling at any time and most often were being held.
  • Brain development is use-dependent: you use it or you lose it.
  • Each moment is a chance to reinforce either positive or negative patterns.
  • Just because a child is older does not mean a punitive approach is more appropiate or effective.
  • We need programs and resources that acknowledge that punishment, deprivation and force merely retraumatize these children and exacerbate their problems.
  • Underneath his frightening behaviour was his own fear and hunger.
  • We have unfortunately gotten into the habit of organizing therapy groups and residential programs in ways that concentrate such children. As we saw in Leon’s case, it can actually server to make problems worse.
  • I cannot emphasize enough how important routine and repetion are to recovery. The brain changes in response to patterned, repetitive experiences: the more you repeat something, the more engrained it becomes. The longer the period of trauma, or the more extreme the trauma, the greater the number of repetitions required to regain balance.
  • Because trauma at its core is an experience of utter powerlessness and loss of control, recovery requires that the patient be in charge of key aspects of the therapeutic interaction.
  • If you push people to open upwhen they aren’t ready, if you require participation in therapy, if you don’t respect individual differences, then your treatment can actually do serious harm.
  • Trauma tends to drive other mental he alth problems like many teen behaviour problems and an enormous percentage of addictions.
  • From birth to age four t he brain grows explosively. The brain of  the four-year-old is 90% adult size.

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