Jul 4, 2009

The Boy Who Was Raised as a Dog

The Boy Who was Raised as a Dog by Bruce Perry & Maia Szalavitz, Basic Books, NY, 2006.

This terrifically engaging and readable book can be thought of as the case-book companion to Dr. Daniel Siegel’s The Developing Mind. Dr. Perry and Ms. Szalavitz, an award winning writer, present eleven stories, hence the subtitle: “And other stories from a Child Psychiatrist’s Notebook. What traumatized children can teach us about loss, love, and healing.” In this book each story describes a child’s trauma, how this affected the child, and what could be done about that. Much of what Dr. Perry presents may not be new, but the manner in which his insights are woven into these stories is wonderful. A major theme is how early maltreatment dysregulates the stress-response system and how this state eventually becomes a trait. He peppers the book with some very interesting tidbits…such as that many children who have experienced chronic early trauma have elevated resting heart rates. This is one of those things that, after reading, I said, Oh, I think I new that, but never really thought about it. (BTW, this helps explain why and how the blood pressure medication, Clonadine can sometimes be helpful for children who experience Complex Post Traumatic Stress Disorder.) When I began asking the families I see to take the pulse of their children while the child was asleep, a large percentage (over half!) reported resting pulse rates of over 110 bpm.

The book emphasizes and underscores the power of relationships to wound and heal. “To calm a frightened child, you must first calm yourself.” This simple and profound statement is echoed throughout the book and can be considered one of the cornerstones of good parenting and treatment. In another section of the book, “The Coldest Heart,” he describes how many traumatized children have a large split between verbal and performance scores and how this reflects imbalances in the brain’s capacity to modulate affect. Although this, and other insights, may seem esoteric, it is the way these insights are woven into very touching stories that make the material memorable and usable.

Each story is both delightful and horrifying to read. Dr. Perry’s compassion and insights are models of how a therapist should act. The stories include the Branch Davidian children and some other famous cases. This is a must read book that should be in every clinician’s bookcase. I have also begun recommending it to parents, who are finding the insights presented very helpful in understanding their child and developing better ways of managing their own feelings.

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