The Boy Who Was Raised as a Dog, Essay Example

In “The Boy Who Was Raised as a Dog,” Dr. Bruce Perry offers overviews of case studies and additional analysis and commentary about a number of children who have experienced trauma and subsequently developed psychological and behavioral disorders. At the heart of Dr. Perry’s thesis is the suggestion that psychological trauma can have profound and lasting physiological effects; simply put, trauma in early childhood can hinder brain development. Dr. Perry’s insights have been acquired over a period of nearly three decades, and in that time our understanding of the intersections of psychology and neurology has evolved significantly. This evolution has been so notable, in fact, that some of what Dr. Perry asserts in his book seems to be common knowledge; it is necessary to remember, however, that what is common knowledge today is built on an ever-expanding base of information. It was not that long ago that the psychological development and physiological development were seen as separate, discrete areas of research. Dr. Perry’s book offers readers concrete examples of how trauma and development are interrelated, as well as providing insight into how the effects of such trauma can be surmounted. For anyone pursuing or engaged in a career in the field of psychology, the lessons learned from this book are invaluable.

While I understand that trauma and psychological disorders are often linked, I was unaware of just how profoundly early childhood trauma could be. Like many people, I do tend to think of children as resilient, a belief that Dr. Perry notes remains common even today. Before beginning his discussion of the case studies featured in the book, Dr. Perry takes time to explain just how wrong this misconception is: not only are children likely to be affected later in life by early trauma, “the impact of (psychological trauma) is actually far greater for children than it is for adults” (Perry, p2). As the author goes on to explain throughout the book how psychological and physiological development are intertwined, it becomes clearer just how damaging psychological trauma can be for children. Adults who experience trauma have at least had the opportunity to develop the physiological structures in the brain that allow them to process that trauma–at least to some extent. For very young children, however, the development of the brain can be short-circuited by trauma in ways that researchers are just now beginning to understand. In several of the case studies in the book (such as that of the “boy who was raised as a dog”) the patients showed physical signs of poor brain development that were unexplained. What Dr. Perry suggests is that the slow or poor development is directly attributable to early-childhood trauma; moreover, he demonstrates how this lack of development can be surmounted through appropriate psychological care.

It is easy to understand why Dr. Perry chose the case of 6-year-old “Justin” as the centerpiece of the book. While each story about each child is as emotionally moving as it is educational, Justin’s story serves as a prime example of everything the author attempts to convey to readers. In the chapter on Justin, Dr. Perry introduces Justin to readers by describing his own introduction to the young boy and the scenario in which he met him. Dr. Perry is faced with a boy who is both physically and psychologically underdeveloped; the child cannot walk, feed himself, or communicate (at least not with spoken words). In order to reach the boy, Dr. Perry must slowly draw him out and earn his trust. It is only after his first meeting with Justin that the doctor begins to get a sense of the trauma the boy experienced, and can begin to connect that psychological trauma with the lack of physiological development evident in the patient’s MRIs and other tests.

As Dr. Perry learns more about Justin, he finds that the young boy has a severely underdeveloped brain and had been diagnosed with “static encephalopathy.” What struck Dr. Perry –and me, as I read this chapter- is that the underlying cause of Justin’s brain damage had never been identified. Moreover, Justin had never received any form of comprehensive, consistent medical care, let alone any form of psychological treatments. The nurses in the PICU wing (where Justin was being treated for pneumonia) seemed resigned to the idea that whatever was wrong with Justin was untreatable, and that there simply was no way to do anything to help improve his situation (aside from offering the most basic care for his pneumonia). Justin was, in fact, being housed in what amounted to a cage while in the hospital’s care. As Dr. Perry soon reveals, this was how he had been raised from the time he was 11 months old.

What struck me the most about this chapter (and, really, throughout the book) was Dr. Perry’s extraordinary level of compassion and empathy not just for his patients, but also for the families and caregivers of these patients. At first glance, the manner in which the nurses in the PICU care for Justin appears to be callously indifferent; Dr. Perry does not view them that way, however. Instead of decrying their lack of empathy or asserting that they were offering inadequate care for Justin, Dr. Perry demonstrates immense patience and understanding. Seen through his eyes, these nurses are not inadequate or indifferent; they simply do not have the knowledge and insight needed to help Justin. Once Dr. Perry begins to approach Justin’s case with an understanding of the relationship between psychological trauma and physiological development, Justin’s situation begins to improve and the hospital staff begins to see his case in a new light.

The same can be said for how Dr. Perry discusses Arthur, Justin’s primary caregiver and the man who “raised (Justin) as a dog.” It would be easy, and entirely understandable, if this caregiver was portrayed as a villain, and as the person responsible for inflicting trauma on the young boy. Yet Dr. Perry speaks kindly and compassionately about Arthur, pointing out that the man’s shortcomings as a caregiver were not driven by malice, but rather by a lack of resources. Arthur did not have the emotional or intellectual resources to properly raise a human child, but he did the best he could under the circumstances. While many (or even most) people would view raising a boy as one would raise dogs as being unconscionably cruel, Dr. Perry makes it clear that such treatment was the only way Arthur knew how to care for any living creature, human or otherwise.

More than anything else in the book, it was this section that moved me the most. It forced me to consider the overriding importance of looking at situations through the perspectives of others. The same talent that Dr. Perry demonstrates for seeing Justin’s case through Arthur’s perspective is what allows the doctor to also see Justin himself in such a manner. By looking at Justin’s case from Justin’s perspective, Dr. Perry is better equipped to determine how to reach the boy and to begin to help him develop the ability to communicate, to walk, and to grow physically and psychologically. This lesson also underscores the importance of not being locked into doing things in only one way, and to instead be willing to learn and grow as a practitioner.

In the discussion of his first case study on “Tina,” Dr. Perry describes an interaction with a supervisor who uses a lot of technical jargon to describe the patient. As he listens to this supervisor, Dr. Perry realizes that the jargon does not properly account for Tina’s problems, and he begins to see a disparity between technical diagnoses and the realities of his patient’s condition and situation.  In the course of this discussion Dr. Perry describes how he began to look for new answers and new connections between physical and psychological problems. While I understood the point he was making, I also began to reflect on how the jargon the supervisor used put distance between himself and the patient. Dr. Perry’s insights allowed me to see his patients as whole people, rather than as a combination of symptoms or diagnoses.

As Dr. Perry writes, “the brain is an historical organ, a reflection of our personal histories.” By learning about the psychological histories of patients, it is possible to gain insight into their physiological development, and their physiological development can shed light on their psychological histories. By understanding the effects that trauma can have on children later in life, both psychologically and physiologically, we can learn more about how to help them overcome that trauma.

Reference

Perry, B. D. and Szalavitz, M. 2006. The boy who was raised as a dog. New York: Basic Books.