The Boy Who Was Raised as a Dog

About the Author

Bruce Perry is a renowned child psychiatrist and neuroscientist, whose contributions to the understanding of childhood trauma have been groundbreaking. As the Senior Fellow of The ChildTrauma Academy, a not-for-profit organization that advances the field of child psychiatry, Perry has dedicated his career to studying how trauma affects the developing brain. His expertise has earned him a position as a professor at the Feinberg School of Medicine in Chicago. Perry is also known for his collaborations with notable figures, including co-authoring the bestseller What Happened to You? with Oprah Winfrey. His profound insights into trauma and healing have shaped modern therapeutic approaches, particularly through the development of the Neurosequential Model of Therapeutics (NMT).

Maia Szalavitz, who co-authored The Boy Who Was Raised as a Dog, is an award-winning journalist with a deep interest in neuroscience and psychology. Her work focuses on the intersection of trauma, addiction, and development, making her an invaluable partner in this exploration of how childhood experiences shape the brain. Together, Perry and Szalavitz weave clinical insights with human stories, making complex scientific concepts accessible and deeply moving.

Main Idea

The central theme of The Boy Who Was Raised as a Dog is the profound and lasting impact of childhood trauma on the developing brain. Perry illustrates how early adverse experiences can alter the brain’s structure and function, leading to significant psychological and behavioral issues later in life. His work challenges the outdated notion that children are inherently resilient and can easily bounce back from trauma. Instead, Perry’s Neurosequential Model of Therapeutics emphasizes the need for developmentally appropriate, brain-based interventions that take into account the timing and nature of traumatic experiences. Through case studies and clinical insights, Perry demonstrates that healing is possible, but it requires a deep understanding of the brain’s development and the creation of nurturing, safe environments for recovery.

Table of Contents

1. Understanding Childhood Trauma
2. The Developing Brain
3. The Stress Response
4. Trauma in Infancy: The Cases of Leon and Laura
5. Trauma at Later Ages: The Case of Tina
6. Dissociation as a Stress Response: The Case of Amber
7. The Neurosequential Model of Therapeutics
8. Implementing the Model: The Cases of Justin, James, and Peter
9. The Importance of Community in Child-Rearing

Understanding Childhood Trauma

Childhood trauma refers to experiences that are so distressing that they overwhelm a child’s ability to cope, leading to lasting psychological and emotional scars. Perry defines trauma as not just the event itself but also the child’s ongoing response to that event. Events such as the loss of a parent, experiencing violence, or enduring neglect can create profound disruptions in a child’s sense of safety and security. The traditional belief that children are naturally resilient and can easily recover from trauma has been debunked by Perry’s research, which shows that trauma can fundamentally alter the way a child’s brain develops, often leading to long-term difficulties in emotional regulation, cognitive processing, and social interactions.

One of Perry’s key insights is that trauma impacts children more deeply than adults because their brains are still developing. The earlier in life the trauma occurs, the more severe the consequences can be. For instance, trauma during the critical periods of brain development can interfere with the formation of neural pathways, leading to difficulties in learning, behavior, and emotional control. Perry notes that around 40% of children in the United States experience one or more traumatic events before reaching adulthood, with some estimates suggesting even higher rates. This highlights the widespread nature of childhood trauma and the urgent need for effective interventions.

"Trauma in childhood is more than a momentary terror; it shapes the very architecture of a child’s brain, determining how they will perceive the world and respond to its challenges." (Bruce Perry)

Perry’s work also challenges the notion that trauma only occurs as a result of extraordinary events. He argues that trauma can also result from chronic, ongoing stressors such as poverty, neglect, or a hostile environment. These types of trauma can be just as damaging as a single traumatic event because they keep the child in a constant state of fear and anxiety, preventing normal brain development. The implications of this are profound, suggesting that millions of children may be struggling with the effects of trauma without ever having experienced what is traditionally considered a traumatic event.

The Developing Brain

To understand how trauma affects children, it is essential to first understand how the brain develops. Perry explains that the brain develops sequentially, with the most basic functions emerging first and more complex functions building on these foundations. The brainstem, which controls basic life functions like heart rate and breathing, develops first. This is followed by the diencephalon and limbic system, which are responsible for emotional responses, and finally, the cortex, which handles higher-level cognitive functions like reasoning and abstract thought.

This developmental sequence is crucial because it means that trauma can disrupt the brain at different stages, depending on when it occurs. For example, trauma that occurs during the early stages of brain development, when the brainstem and limbic system are still forming, can lead to problems with emotional regulation and stress response. On the other hand, trauma that occurs later, when the cortex is developing, can affect a child’s ability to think critically and make decisions.

The brain’s development is not automatic; it requires specific types of stimulation, particularly from caregivers, to develop properly. For example, a child needs to be held, talked to, and comforted in order to develop healthy emotional responses. If a child is neglected or abused, they may not receive the necessary stimulation, leading to stunted brain development. Perry emphasizes that the brain is particularly vulnerable during the first few years of life, when it is most plastic and responsive to environmental influences.

"The brain’s development is like constructing a building. If the foundation is unstable, the entire structure is compromised. Trauma shakes that foundation." (Bruce Perry)

This understanding of brain development has significant implications for treatment. It suggests that interventions must be tailored to the specific stage of brain development at which the trauma occurred. For example, a child who experienced trauma during infancy may need different types of therapy than a child who experienced trauma during adolescence. This is the foundation of Perry’s Neurosequential Model of Therapeutics, which we will explore in more detail later.