The Boy Who Was Raised as a Dog by Bruce Perry and Maia Szalavitz
Book Review by Carol Ladas-Gaskin
We were directed to reading this book by a cryptic email from Ron Kurtz, founder of the Hakomi method. The email was addressed to a long list of students and graduates of Hakomi trainings, people who understand and appreciate Ron’s sense of humor and his unerring recommendations for good reading. It read: “If you don’t read this book, I’m going to kill myself.”
Recommended by Ron Kurtz
Shortly after we read the book, another recommendation arrived from our colleague Rob Bageant, Hakomi therapist, teacher and trainer now working Taiwan. He wrote, “(They) write with a novelist’s sense of structure. My heart aches to hear what these children have experienced; I can hardly read the case studies. And yet, I believe that anyone interested in more deeply understanding what it means to be human should read this book. The Boy Who was Raised as a Dog has a lot of answers. Through hard won experience, Perry and Szalavitz have ferreted out the neurological effects of trauma as well as the practical therapeutic approaches which help heal the wounds.” A client and workshop participant, who has experienced encounters with psychiatrists of a less compassionate persuasion, read the book recently and left a touching phone message conveying how this book has changed her attitude about psychiatrists and psychiatry.
The Boy who was Raised by a Dog is a memoir of a Bruce Perry’s growth and development as a psychiatrist working with children suffering from severe trauma. Bruce Perry, M.D., Ph.D. is a senior fellow of the Child Trauma Academy. He has served as a consultant to the FBI (concerning the Waco disaster) and is the former chief of psychiatry at Texas Children’s hospital as well as former Vice Chairman for Research in the Dept. of Psychiatry at Baylor College of Medicine. His co-author Maia Szalavitz is author of Help at any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids and Recovery Options: The Complete Guide written with Jospeh Volpicelli, M.D., Ph.D. Although the book is written by both Perry and Slalavitz, the stories themselves are written as experiences had by Perry, so the review will speak of him rather than them.
It is rare to find a book so informative and practical and yet inspiring to read. As practitioners of a method, Mindfulness Centered Therapies, based in part on the teachings of Ron Kurtz’ and as clinicians who long ago discovered the healing power of mindfulness, compassionate presence and following the client, we find this book to be an affirmation of all of the principles of our work and the methods we teach. Perry’s life-affirming approach with his respectful, kind, profoundly attentive and innovative, mindful presence embodies the work of our teachers, to mention a few, Carl Rogers, Ron Kurtz, Eugene Gendlin, and Richard Schwartz.
One of Perry’s most important conclusions after years of his clinical work is that “the infant/child is highly susceptible to trauma and stress in the first three years of life. …. The earlier view that children are inherently resilient is false.” Add to this his observation that many times, early childhood trauma is misdiagnosed as ADHD and since many of the diagnostic symptoms are identical, this is of crucial significance. Perry is very innovative and creative in his approach to working with these severely traumatized children and their families and peers. He says: “A sincere, kind act, it seemed to me, could have more therapeutic impact than any artificial, emotionally regulated stance that so often characterizes “therapy.” Fire can warm or consume, water can quench or drown; wind can caress or cut. And so it is with human relationships: we can create and destroy, nurture and terrorize, traumatize and heal each other. Like other teachers, clinicians, and researchers who had inspired me, my teacher encouraged exploration, curiosity and reflection, but most importantly gave me courage to challenge existing beliefs.”
The book is available in paperback and consists of a series of eleven amazing vignettes each describing Perry’s experience and interactions with a severely traumatized child or a group of children. Their back stories range from severe sexual and physical abuse of individual children to survivors of the Waco disaster to the title story about a boy who was literally raised as a dog.
Woven throughout these stories we see the qualities of gentle curiosity, attunement and an attentiveness born of a remarkable sensitivity to non verbal communication and a commitment to non-violence in even the most subtle form. These healing practices provide room for the client, in this case a traumatized child, to be an active agent in the process of healing, free to titrate his or her experience and the pace of the healing. It is clear that Perry has learned to trust his own creativity and the power of relatedness. He seems to have an unerring ability to discover the action, words and atmosphere that are inherently nourishing and healing to the child in the moment. His transparent expression of this process provides a deep teaching for all of us in the healing profession.
He says, regarding choice and self direction,“One of the defining elements of traumatic experience – particularly one that is so traumatic that one dissociates because there is no escape from it – is a complete loss of control and a sense of utter powerlessness. As a result, gaining control is an important aspect of coping with traumatic stress. To develop a self, one must exercise choice and learn from consequences. The process needs to be self directed and the child (client) needs to be in control of the timing.
Perry’s own inner work is evident in these words, “As a therapist, caregiver, parent, friend we need to be clear that in order to calm a child (client), you must first calm yourself.” Although, he cautions, that immediate debriefing after a traumatic event “is often intrusive, unwanted and may actually be counter-productive. What is needed is presence, appropriate timing (pace), structure not rigidity and nurturance but not forced affection.”
Throughout the book in addition to the stories and the process of working with the children, Perry and Slalavitz share neurological details regarding the brain, memory and association that are the foundation of his therapeutic practice. He has discovered that children become resilient and able to access effective memory as a result of repetitive, moderate, predictable patterns of stress and nurturing and that these patterns make a system stronger and more functionally capable creating “a resilient, flexible stress response capacity.” Systems in the brain that are repeatedly activated will change and the systems that don’t get activated won’t change. Through association, which underlies both language and memory, we weave all of our incoming sensory signals together – sound, sight, touch, scent – to create the whole person. His actual stories of working with these children illustrate the practice of his understanding in real life.
Millions of tiny decisions are made in the life of each person, seemingly irrelevant but often profound choices that determine the entire life direction of a child. Honoring, respecting and acknowledging distressing experiences and strong emotions with a sense of appropriate timing and space creates a profound context for healing. Although these stories are all focused on therapeutic work with children, it is clear in reading the book that the work would be welcomed, by adults, as well, who long to be met with such sensitivity and presence.
Though each of these stories is heartbreaking, Perry and Slavitz write with such compassion they inspire us to bring creativity and courage to our work with all our clients. Not only is this a heart opening and affirming book about the power of relationship, and what is possible in our work as therapists, but it is an inspiration to bring our personhood, creativity and imagination and especially our compassion to clinical work. These stories are almost impossible to put down, and the teaching found within them is priceless.
To close, in Perry’s words, “most therapeutic experiences take place in naturally occurring healthy relationships. Anything that increases the quality and number of healthy relationships in the child’s life is helpful. The experience of safe touch is invaluable if it is freely chosen.”
Quotes from The Boy Who Was Raised as a Dog by Bruce D. Perry, M.D., Ph.D. and Maia Szalavitz compiled by Carol Ladas-Gaskin and J. David Cole