The Boy Who Was Raised as a Dog

by Bruce Perry

  But what I thought, at first, would be just another piece of the puzzle turned out to be the most important element: Peter’s school and, especially, his classmates. As I looked over his history, I suddenly recognized that most of Peter’s progress had come in the first three years after he came to the United States: when he spent his time alone with his parents, or with adults, or one or two peers selected by them.

  When he began attending kindergarten, however, his progress had ceased and his behavior problems had intensified. His mother had intuitively understood that he was chronologically six but behaviorally two, but his classmates couldn’t comprehend why he behaved so strangely. Even his teacher didn’t know how to handle him, despite having been told of his background. Peter would grab toys from other children without asking, missing the social cues the other kindergartners understood about when it was OK to take something and when it wasn’t. He didn’t understand when he should share his things and when to keep them to himself, when he should speak and when he should be quiet. At circle time he’d suddenly get up and slip into the teacher’s lap or begin to wander around without realizing he wasn’t supposed to. And he’d sometimes shriek and have his terrifying tantrums.

  As a result the other children began to fear and marginalize him. His oddly accented English didn’t help. His classmates viewed him as a strange and frightening boy. He’d done well in the sheltered world of his adoptive home, with one-on-one relationships with adults who knew and loved him. But the complex social world of kindergarten, with its varying peer and teacher relationships to negotiate, was beyond him.

  Instead of the patient, nurturing, loving responses he got at home, at kindergarten his behavior was met with suspicion and, often, outright rejection. The classroom filled with noisy children and loud toys and frequent movement was overwhelming to him. Where once he understood what was expected of him and was treated gently if he wasn’t able to do it, now he couldn’t figure out what was going on. No matter how many hours of healthy positive experiences Peter had each week, the hours when he was marginalized or teased could easily overshadow them.

  Peter had no real friends and preferred to play with much younger children; he felt most comfortable with three- or four-year-olds. His own classmates didn’t know what to make of the boy who talked funny and often acted like a baby. In many situations children can be kind and nurturing to someone who appears to be younger and more vulnerable. But Peter frightened them.

  The behavior of his classmates was predictable. What was happening was a small version of what happens all across the planet in various forms every day. Human beings fear what they don’t understand. The unknown scares us. When we meet people who look or act in unfamiliar or strange ways, our initial response is to keep them at arm’s length. At times we make ourselves feel superior, smarter or more competent by dehumanizing or degrading those who are different. The roots of so many of our species’s ugliest behaviors—racism, ageism, misogyny, anti-Semitism, to name just a few—are in this basic brain-mediated response to perceived threat. We tend to fear what we do not understand, and fear can so easily twist into hate or even violence because it can suppress the rational parts of our brain.

  Faced with Peter’s growing ostracism and social rejection, Amy and Jason wanted to know what to do: should they hold him back in kindergarten, hoping he’d learn more socially the second time around? Yet his cognitive abilities were clearly on grade level for first grade, perhaps higher.

  Peter was intellectually advanced, but socially clueless. I realized that if he was going to catch up, he was going to need the help of his peers. It seemed to me that we might as well try letting him start first grade. When I had worked with adolescents, some of them had allowed me to talk with their classmates about their traumatic experiences and the effect it had on their brain. A bit of understanding had gone a long way in helping improve their social lives. But could this work with first graders? And would Peter find it acceptable?

  I knew that I would be in his hometown several weeks after his evaluation and could talk to his classmates at that time. I went back to explore this possibility with Peter. As we were coloring, I asked, “Peter, do you remember living in Russia?”

  He stopped and looked at me for a moment. I kept slowly coloring, not looking back at him. The pace of his coloring slowed. I was just about to ask again when he took a new sheet of paper and drew a big blue circle around the entire page.

  “This is Russia.” He held the page up to me. He placed the paper back on the floor, took a color and made one tiny, delicate, almost invisible dot. “And this is Peter.” I looked at him; he was clearly sad. He was eloquently expressing how he felt at the orphanage, where he’d been special to no one, just one of dozens of anonymous babies.

  I smiled sympathetically at him, then raised my eyebrows and said, “But that isn’t Peter anymore, is it?” He shook his head no, and smiled back.

  “Peter, I was thinking that I would come to your first grade class to visit.” I wasn’t sure he would understand, but I wanted him to know what I wanted to do and why.

  “OK.”

  “You know how we have talked about how your brain is growing and changing? I was wondering if you would mind if I talked to your class about the brain. And maybe a little about the way you lived before you came to live with your parents?”

  “OK,” he said, thoughtfully, adding, “Will you bring the pictures?”

  “Which pictures?”

  “The pictures of my brain.”

  “Sure. You won’t mind if I show pictures of your brain to your class?”

  “No. My brain is cool.”

  “You know, Peter, you are so right. Your brain is cool.” And so, with his permission and with that of his parents and his school, I decided to see if I could make first graders into a new community of “therapists” for Peter.

  I addressed his first grade class at the beginning of the school year. “I’m Peter’s friend,” I said. “I study the brain and Peter asked me to come from Houston to tell you some of the things about the brain that I taught him.” I had Peter come up to the front of the class and serve as my assistant.

  I told the first graders about the brain, and about how in some ways, it acts like a muscle. I talked about how they were exercising their “ABC” muscles in school and about the importance of repetition. I described how they had many other similar kinds of “muscles” in their brains that also needed certain kinds of attention in order to grow big and strong. I talked about how the brain develops and what makes everyone’s brain work, emphasizing how the brain changes.

  “Remember, Peter, when we were talking about how it takes a lot of practice to learn anything new? That is because the brain changes when you use it, use it, use it.”

  I looked at the children and then back at Peter, “Right, Peter?” He smiled and nodded. “And that is why your teacher keeps having you practice writing again and again; and practice your letters again and again and again.”

  I showed some slides; I brought a model of the brain and Peter passed it around. I answered questions. What part of the brain makes you talk? What color is the brain? Does the brain keep videos of your life?

  I told the children how important it was for a developing baby’s brain to get stimulation from talk and touch and human interactions. I told them the same things that I told parents, judges, pediatricians and my own staff, just with fewer big words.

  Then I talked a little bit about how different children grow up in different homes. How Japanese children learn Japanese; how in some cultures mothers carry their babies around all day long during their first year of life. How some children don’t get as much touch or talk or love early in life, and how that can change the brain. They were having fun. We laughed.

  Peter was smiling. Then, it was time. I didn’t know how much I would say, or even what I would say. I would let the response of the children—and Peter—guide me. I jumped in, “Well. Thank you for letting me come to your classr
oom. Peter told me about you guys when he came to visit me in Houston. I know he went to kindergarten with many of you.” A few of the children raised their hands. “We asked Peter to come to our clinic in Houston because we wanted to learn from him about his amazing brain.”

  The children looked at Peter. “See, when he was a little boy he spent every minute of every day for the first three years of his life in one crib.” The children looked interested, but kind of confused. “Peter was born in another country where they did not know very much about the brain. His parents could not take care of him so Peter went to an orphanage when he was just a baby. In this orphanage each baby was put in a crib and that was their home. They didn’t get to wander around, crawl anywhere, or even practice standing so they could learn to walk. Until his parents came to get him when he was three, Peter never had a chance to walk around, to play with friends, to get a hug from any loving grown-ups. His brain didn’t get very much stimulation.” The room was completely silent: twenty-six six-year-old children didn’t move, speak or fidget.

  “And then when he was three, his new parents came and brought him to live in Tulsa.” I paused to let some of the tension dissipate. “And that is when Peter’s amazing brain started to learn so many things. Even though he had never heard English, he learned English in just a couple years. He had never had a chance to walk or run or skip and he learned to do all of those things.” Peter looked embarrassed. I didn’t want to push too much. “And so even today, Peter’s amazing brain is learning. He has really done great. And that is why we wanted to meet Peter and learn more about how any person with such a hard start in life could do so well.”

  Then I ended with, “Part of what we learned is that every day in school, Peter learns things from all of you. He watches how you do things, he learns from playing with each of you and he learns from just being your friend. So thank you for helping Peter. And thanks for letting me come and talk about the brain.”

  It was a short and simple talk. I tried to take an unknown—Peter—and make him less frightening to these children. And over time, their natural goodness emerged. No longer an odd and scary boy, Peter became popular—so popular, in fact, that his peers would argue over who got to sit next to him, who got to be his partner, who got to be in his group. The brightest and strongest children in his class took a special interest in him and their leadership made all the difference. They included him, protected him and, ultimately, provided therapeutic experiences that helped Peter catch up.

  They were tolerant of his developmental problems, patient in correcting his social mistakes and nurturing in their interactions. These children provided many more positive therapeutic experiences than we ever could have given Peter.

  Children, just like us adults, react badly to the unknown, to the strange and unfamiliar, especially when they themselves are trying to adjust to a new situation like the start of a school year. Although their social hierarchies aren’t always so easy to influence, most bullying and social rejection begins with fear of the unfamiliar, and adults have much more influence over the process than they may believe. When children understand why someone behaves oddly, they give him or her more slack, generally. And the younger the children are, the more easily they are influenced by both obvious and subtle cues of rejection and acceptance from adults. These cues often set the tone for the children’s status systems, and teachers and parents can either minimize bullying or unfortunately, maximize it, by either strongly discouraging or tolerating the scapegoating of those who are “different.”

  Knowing that Peter’s immature behavior came from his history of deprivation helped his classmates reinterpret it. When he grabbed something or talked out of turn, they no longer saw it as a personal affront or jarring oddity, but simply as a remnant from his past that they’d been taught to expect. The results were rapid: almost immediately he stopped having tantrums and outbursts, probably because what had prompted them was frustration, a sense of rejection and feeling misunderstood. Because the other children were more forgiving and more explicit about the social cues they were giving him, he was able to read them better and thus able to fit in better. What had been a downward spiral of rejection, confusion and frustration became instead a cascade of positive reinforcement, which fed on itself. The huge gaps in developmental age across emotional, social, motor and cognitive domains slowly filled in. By the time Peter reached high school he no longer stood out and he has continued to do well, both academically and socially.

  His peers and his family healed him by creating a rich social world, a nurturing community. While the neurosequential approach helped us provide the specific stimuli his brain had lacked, massage offering the physical affection that he’d missed, and music and movement to help restore his brain and bodily rhythms, none of that would have been enough without Amy and Jason’s love and sensitivity and without the patience and support of his classmates. The more healthy relationships a child has, the more likely he will be to recover from trauma and thrive. Relationships are the agents of change and the most powerful therapy is human love.

  chapter 11

  Healing Communities

  IT HAS BEEN an extraordinary privilege to work with the children whose stories I have shared here—and I have learned a tremendous amount from them. I have been consistently amazed by their courage, their strength and their ability to cope with situations that most adults would find unbearable. But while emerging therapeutic models like the neurosequential approach hold great promise, my experience as well as the research suggests that the most important healing experiences in the lives of traumatized children do not occur in therapy itself.

  Trauma and our responses to it cannot be understood outside the context of human relationships. Whether people have survived an earthquake or have been repeatedly sexually abused, what matters most is how those experiences affect their relationships—to their loved ones, to themselves and to the world. The most traumatic aspects of all disasters involve the shattering of human connections. And this is especially true for children. Being harmed by the people who are supposed to love you, being abandoned by them, being robbed of the one-on-one relationships that allow you to feel safe and valued and to become humane—these are profoundly destructive experiences. Because humans are inescapably social beings, the worst catastrophes that can befall us inevitably involve relational loss.

  As a result, recovery from trauma and neglect is also all about relationships—rebuilding trust, regaining confidence, returning to a sense of security and reconnecting to love. Of course, medications can help relieve symptoms and talking to a therapist can be incredibly useful. But healing and recovery are impossible—even with the best medications and therapy in the world—without lasting, caring connections to others. Indeed, at heart it is the relationship with the therapist, not primarily his or her methods or words of wisdom, that allows therapy to work. All the children who ultimately thrived following our treatment did so because of a strong social network that surrounded and supported them.

  What healed children like Peter, Justin, Amber and Laura were the people around them, their families, their friends, the folks who respected them, who were tolerant of their weaknesses and vulnerabilities and who were patient in helping them slowly build new skills. Whether it was the coach who allowed Ted to keep team statistics, Mama P. who helped teach Virginia how to nurture Laura, the first graders who took Peter under their wing and protected him, or the incredible adoptive parents of so many of my patients—all of them provided the most important therapy that these children ever received. Because what they needed most was a rich social environment, one where they could belong and be loved.

  What maltreated and traumatized children most need is a healthy community to buffer the pain, distress and loss caused by their earlier trauma. What works to heal them is anything that increases the number and quality of a child’s relationships. What helps is consistent, patient, repetitive loving care. And, I should add, what doesn’t work is well-intended but poorly
trained mental health “professionals” rushing in after a traumatic event, or coercing children to “open up” or “get out their anger.”

  However, because it is exactly those children who are most vulnerable to trauma who are least likely to have a healthy, supportive family and community, it is exceedingly difficult to provide effective help through the current systems we have in place. Because healthy communities themselves are often what prevents interpersonal traumatic events (like domestic violence and other violent crime) from occurring in the first place, the breakdown of social connection that is common in our highly mobile society increases everyone’s vulnerability.

  If we are to successfully raise healthy children, children who will be resilient in the face of any traumatic experience they may encounter—and some 40 percent of children will experience at least one potentially traumatic event before they become adults—we need to build a healthier society. The wonderful thing about our species is that we can learn; our memories and our technologies allow us to benefit from the experience of those who came before us. But at the same time those technologies, even the ones that are presumably meant to bring us together, are increasingly keeping us apart. The modern world has disrupted and in many cases abandoned the fundamental biological unit of human social life: the extended family. There has been so much emphasis on the breakdown of the nuclear family, but I believe that in many cases the extended family, whose dissolution has been much less discussed, is at least as important. It certainly, as you may recall from Leon’s story, can make the difference between a young couple who are able to cope and raise a healthy child and one where one or both parents becomes overwhelmed and neglectful.