Book Review: Transforming trauma

The title of child psychiatrist Bruce Perry’s book, The Boy Who Was Raised as a Dog, promises a compelling read — and it delivers. In each of his 12 page-turning chapters, Perry draws on his years of treating traumatized children to present lessons on loss, love and healing. The case stories are accompanied by easily understood analysis of potential treatment options. 

Bruce Perry

Research in the last few years has amply demonstrated the lasting impact of childhood trauma. As Perry explains in his introduction, roughly one-third of children who are abused will have some clear psychological problems as a result, and even purely physical problems such as heart disease or cancer can be more likely to affect traumatized children later in life.

The book is filled with stories of trauma, but many are also stories of transformation. The patient responsible for the book’s title, Justin, was raised through age 5 by a well-intentioned but socially immature man who made his living as a dog breeder. When he couldn’t cope with the infant Justin’s demands, he treated him as he would his animals, primarily by keeping him in a cage and interacting with him as he did his animals. When Perry first came in contact with Justin in the hospital, the boy was unable to speak, walk or tolerate physical interaction. Staff members assumed he was irretrievably damaged, both mentally and physically.

Perry began by taking a complete history, and discovered for the first time the circumstances of his upbringing. He moved Justin out of a busy ward into a room where sensory overload could be minimized, then he and several specialists began working with him daily — always attuned to the child’s tolerance for interaction. The child made rapid progress and soon was placed with a foster family.

What did he learn from Justin’s case? That patterned, repetitive experience in a safe environment can have an enormous impact on the brain.

Scientific approach

In his treatment of children, Perry takes what he calls a “neurosequential” approach. The child’s age at the time of the traumatic incident determines the gaps in neurological development, and his treatment focuses on sequentially targeting brain regions left undeveloped by abuse or neglect. Children who suffered trauma in infancy, for example, will benefit from therapy featuring healing touch or rhythm before moving on to higher brain activities.

At the heart of his theory is the belief that if you give children appropriate routine and repetition, their brains will work towards recovery. “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.” 

Although heavy with scientific and behavioral theory, Perry’s evidence-based approach is easily understandable by laypeople reading the book for insight in dealing with the children in their own lives. It’s a fascinating read with practical conclusions that can help in many situations.  

Residents of Oregon and Siskiyou County can get this book for free from the Foundation's Select Books program.

Order: The Boy Who Was Raised as a Dog