The Boy Who Was Raised as a Dog
Table of Contents
Praise
Title Page
Dedication
Author’s Note
Introduction
chapter 1 - Tina’s World
chapter 2 - For Your Own Good
chapter 3 - Stairway to Heaven
chapter 4 - Skin Hunger
chapter 5 - The Coldest Heart
chapter 6 - The Boy Who Was Raised as a Dog
chapter 7 - Satanic Panic
chapter 8 - The Raven
chapter 9 - “Mom Is Lying. Mom Is Hurting Me. Please Call the Police.”
chapter 10 - The Kindness of Children
chapter 11 - Healing Communities
Appendix
Acknowledgements
Notes
Index
Copyright Page
Praise for The Boy Who Was Raised as a Dog
“I have never encountered a child advocate with a better mind, a bigger heart, or a more generous spirit than Bruce Perry. This book captures the essence of his insights and the heroism of his actions on behalf of children who have encountered the dark side of human experience.”
—JAMES GARBARINO, PH.D., author of Lost Boys: Why Our Sons Turn Violent and How We Can Save Them
“The Boy Who Was Raised as a Dog is Bruce Perry’s finest achievement. . . . It gives us the opportunity to unlock the deepest mystery of our species: why some children turn out to be heroes and others to be predatory sociopaths. Anyone who wants to understand childhood trauma and its heartbreaking consequences must read this book.”
—ANDREW VACHSS, best-selling author of Mask Market and founder and national advisory board member of PROTECT: The National Association to Protect Children
“Filled with compassionate, caring stories by a wise healer and scientist, this book will appeal to all who are interested in understanding how children heal.”
—LYNN PONTON, M.D., author of The Romance of Risk
“I have admired and respected Bruce Perry for over a decade. His commitment to helping young children raised in chaotic and abusive environments is nothing short of remarkable. This book is an important tool in helping us understand the critical impact of early experiences in children’s lives, and it shows us how to help those who have been damaged by neglect. Anyone who deals with vulnerable or troubled youth—from social workers to judges, daycare workers to high school teachers, parents to politicians—can gain important perspectives from this book.”—ROB REINER
“In this harrowing but profoundly humane book, Perry and Szalavitz provide an all too timely, utterly engrossing account of traumatized children’s lives. . . . Once I opened it, I could not put it down.”
—SARAH BLAFFER HRDY, author of Mother Nature: Maternal Instincts and How They Shape the Human Species
“For many years, Bruce Perry’s work has been deserving of our highest praise. This book is his crowning achievement, the ultimate combination of science and humanity.”
—JOEL A. DVOSKIN, PH.D., ABPP, University of Arizona College of Medicine, and President, American Psychology-Law Society
Bruce D. Perry:
For my Clan
Barbara, Jay, Emily, Maddie, Elizabeth,
Katie, Martha, Robbie
In memory of Arlis Dykema Perry (1955-1974)
Maia Szalavitz:
For my mother, Nora Staffanell
Author’s Note
The stories in this book are all true, but in order to ensure anonymity and protect privacy, we have altered identifying details. The children’s names have been changed, as have the names of their adult family members if that information would identify the child. All other adult names are real names, except those identified with an asterisk. Despite these necessary changes, the essential elements of each case are reported as accurately as possible. Conversations, for example, are depicted as recalled and/or as recorded in notes, audio tapes or video.
The sad reality is that these stories are but a tiny percentage of the many we could have told. Over the last ten years our clinical group at the ChildTrauma Academy has treated more than a hundred children who have witnessed the murder of a parent. We have worked with hundreds of children who endured severe early neglect in institutions or at the hands of their parents or guardians. We hope that the strength and spirit of the children whose stories we tell in this book, and the many others who have suffered similar fates, come through on these pages.
Introduction
IT’S HARD TO IMAGINE today, but when I was in medical school in the early 1980s researchers didn’t pay much attention to the lasting damage that psychological trauma can produce. Even less consideration was given to how trauma might harm children. It wasn’t considered relevant. Children were believed to be naturally “resilient,” with an innate ability to “bounce back.”
When I became a child psychiatrist and neuroscientist, it was not my goal to refute this misguided theory. But then, as a young researcher, I began to observe in the lab that stressful experience—particularly in early life—could change the brains of young animals. Numerous animal studies showed that even seemingly minor stress during infancy could have a permanent impact on the architecture and the chemistry of the brain and, therefore, on behavior. I thought: why wouldn’t the same be true for humans?
That question became even more salient to me as I began my clinical work with troubled children. I soon found that the vast majority of my patients had lives filled with chaos, neglect and/or violence. Clearly, these children weren’t “bouncing back”—otherwise they wouldn’t have been taken to a child psychiatry clinic! They’d suffered trauma—such as being raped or witnessing murder—that would have had most psychiatrists considering the diagnosis of post-traumatic stress disorder (PTSD), had they been adults with psychiatric problems. And yet these children were being treated as though their histories of trauma were irrelevant, and they’d “coincidentally” developed symptoms, such as depression or attention problems, that often required medication.
Of course, the diagnosis of PTSD was only itself introduced into psychiatry in 1980. At first, it was seen as something rare, a condition that only affected a minority of soldiers who had been devastated by combat experiences. But soon the same kinds of symptoms—intrusive thoughts about the traumatic event, flashbacks, disrupted sleep, a sense of unreality, a heightened startle response, extreme anxiety—began to be described in rape survivors, victims of natural disaster and people who’d had or witnessed life-threatening accidents or injuries. Now the condition is believed to affect at least 7 percent of all Americans and most people are familiar with the idea that trauma can have profound and lasting effects. From the horrors of the 9/11 terrorist attacks to the aftermath of Hurricane Katrina, we recognize that catastrophic events can leave indelible marks on the mind. We know now—as my research and that of so many others has ultimately shown—that the impact is actually far greater on children than it is on adults.
I have made it my life’s work to understand how trauma affects children and to develop innovative ways to help them cope with it. I have treated and studied children faced with some of the most horrendous experiences imaginable—from the surviving victims of the Branch Davidian cult conflagration in Waco, Texas, to neglected Eastern European orphans, to genocide survivors. I have also helped courts sort through the wreckage of misguided “Satanic Ritual Abuse” prosecutions based on coerced accusations from tortured, terrified children. I have done my best to help children who witnessed their parents’ murders, and those who’ve spent years chained in cages or locked in closets.
While most children will never suffer anything as awful as what many of my patients have undergone, it is the rare child who
escapes trauma entirely. By conservative estimates, about 40 percent of American children will have at least one potentially traumatizing experience by age eighteen: this includes the death of a parent or sibling, ongoing physical abuse and/or neglect, sexual abuse, or the experience of a serious accident, natural disaster or domestic violence or other violent crime.
In 2004 alone an estimated three million official reports of child abuse or neglect were made to government child protection agencies; around 872,000 of these cases were confirmed. Of course, the true number of abused and neglected children is far higher because most cases are never reported and some genuine cases cannot be sufficiently corroborated for official action to be taken. In one large survey, about one in eight children under the age of seventeen reported some form of serious maltreatment by adults within the past year, and about 27 percent of women and 16 percent of men report as adults having been sexually victimized during childhood. In a national survey conducted in 1995, 6 percent of mothers and 3 percent of fathers even admitted to physically abusing their children at least once.
Furthermore, up to ten million American children are believed to be exposed to domestic violence annually and 4 percent of American children under the age of fifteen lose a parent to death each year. Also, each year some 800,000 children will spend time in foster care and millions more are victims of natural disasters and devastating automobile accidents.
Although I do not mean to imply that all of these children will be severely “damaged” by these experiences, the most moderate estimates suggest that at any given time, more than eight million American children suffer from serious, diagnosable, trauma-related psychiatric problems. Millions more experience less serious but still distressing consequences.
Roughly one third of children who are abused will have some clear psychological problems as a result—and research continues to show how even seemingly purely “physical” problems like heart disease, obesity and cancer can be more likely to affect traumatized children later in their lives. Adults’ responses to children during and after traumatic events can make an enormous difference in these eventual outcomes—both for good and for ill.
Over the years research from my lab and many others has produced a much richer understanding of what trauma does to children and how we can help them heal from it. In 1996 I founded The ChildTrauma Academy, an interdisciplinary group of professionals dedicated to improving the lives of high-risk children and their families. We continue our clinical work and still have much to learn, but our primary goal is to bring treatments based on the best of our existing knowledge to others. We train people who work with children—whether they are parents or prosecutors, police officers or judges, social workers, physicians, policy makers or politicians—to understand the most effective ways of minimizing the impact of trauma and maximizing recovery. We consult with government agencies and other groups to help them implement the best practices in dealing with these issues. My colleagues and I travel extensively around the world, speaking to parents, doctors, educators, child protection workers and law enforcement officials, as well as high level stakeholders such as legislative bodies or committees and concerned corporate leaders. This book is part of our efforts.
In The Boy Who Was Raised as a Dog you’ll meet some of the children who taught me the most important lessons about how trauma affects young people. And you’ll learn what they need from us—their parents and guardians, their doctors, their government—if they are to build healthy lives. You’ll see how traumatic experience marks children, how it affects their personalities and their capacity for physical and emotional growth. You’ll meet my first patient, Tina, whose experience of abuse brought home to me the impact of trauma on children’s brains. You’ll meet a brave little girl named Sandy, who at the age of three had to be put in a witness protection program, and who taught me the importance of allowing a child to control aspects of her own therapy. You’ll meet an astonishing boy called Justin, who showed me how children can recover from unspeakable deprivation. Each child I’ve worked with—the Branch Davidian children, who took comfort in caring for each other; Laura, whose body didn’t grow until she felt safe and loved; Peter, a Russian orphan whose first grade classmates became his “therapists”—helped my colleagues and me place a new piece in the puzzle, allowing us to advance our treatment for traumatized children and their families.
Our work brings us into peoples’ lives when they are most desperate, alone, sad, afraid and wounded, but for the most part the stories you’ll read here are success stories—stories of hope, survival, triumph. Surprisingly, it is often when wandering through the emotional carnage left by the worst of humankind that we find the best of humanity as well.
Ultimately, what determines how children survive trauma, physically, emotionally, or psychologically, is whether the people around them—particularly the adults they should be able to trust and rely upon—stand by them with love, support and encouragement. Fire can warm or consume, water can quench or drown, wind can caress or cut. And so it is with human relationships: we can both create and destroy, nurture and terrorize, traumatize and heal each other.
In this book you will read about remarkable children whose stories can help us better understand the nature and power of human relationships. Although many of these boys and girls have had experiences far more extreme than most families will encounter (and thank goodness for that), their stories carry lessons for all parents that can help their children cope with the inevitable stresses and strains of life.
Working with traumatized and maltreated children has also made me think carefully about the nature of humankind and the difference between humankind and humanity. Not all humans are humane. A human being has to learn how to become humane. That process—and how it can sometimes go terribly wrong—is another aspect of what this book is about. The stories here explore the conditions necessary for the development of empathy—and those that are likely, instead, to produce cruelty and indifference. They reveal how children’s brains grow and are molded by the people around them. They also expose how ignorance, poverty, violence, sexual abuse, chaos and neglect can wreak havoc upon growing brains and nascent personalities.
I have long been interested in understanding human development, and especially in trying to figure out why some people grow up to be productive, responsible, and kind human beings, whereas others respond to abuse by inflicting more of it on others. My work has revealed to me a great deal about moral development, about the roots of evil and how genetic tendencies and environmental influences can shape critical decisions, which in turn affect later choices and, ultimately, who we turn out to be. I do not believe in “the abuse excuse” for violent or hurtful behavior, but I have found that there are complex interactions beginning in early childhood that affect our ability to envision choices and that may later limit our ability to make the best decisions.
My work has taken me to the intersection of mind and brain, to the place where we make choices and experience influences that determine whether or not we become humane and truly human. The Boy Who Was Raised as a Dog shares some of what I’ve learned there. Despite their pain and fear, the children in this book—and many others like them—have shown great courage and humanity, and they give me hope. From them I have learned much about loss, love and healing.
The core lessons these children have taught me are relevant for us all. Because in order to understand trauma we need to understand memory. In order to appreciate how children heal we need to understand how they learn to love, how they cope with challenge, how stress affects them. And by recognizing the destructive impact that violence and threat can have on the capacity to love and work, we can come to better understand ourselves and to nurture the people in our lives, especially the children.
chapter 1
Tina’s World
TINA WAS MY FIRST child patient, just seven years old when I met her. She sat in the waiting room of the University of Chicago child psychiatry clinic: tiny and fragile, huddle
d with her mother and siblings, unsure what to expect from her new doctor. As I led her to my office and shut the door, it was hard to tell which one of us was more nervous: the three-foot-tall African-American girl with meticulously neat braids or the six-foot-two white guy with the long mane of unruly curls. Tina sat on my couch for a minute, checking me out, looking me up and down. Then, she walked across the room, crawled into my lap and snuggled in.
I was touched. Gosh, what a nice thing to do. What a sweet child. Stupid me. She shifted slightly and moved her hand to my crotch and tried to open my zipper. I was no longer anxious. Now, I was sad. I took her hand, moved it from my thighs, and carefully lifted her off my lap.
The morning before I first met with Tina I read through her “chart”—one small sheet of paper with minimal information taken during a phone interview with our intake worker. Tina lived with her mother, Sara, and two younger siblings. Sara had called the child psychiatry clinic because her daughter’s school had insisted that she get her evaluated. Tina had been “aggressive and inappropriate” with her classmates. She’d exposed herself, attacked other children, used sexual language and tried to get them to engage in sex play. She didn’t pay attention in class and often refused to follow directions.
The most relevant history the chart contained was that Tina had been abused for a two-year period that started when she was four and ended when she was six. The perpetrator was a sixteen-year-old boy, her babysitter’s son. He had molested both Tina and her younger brother, Michael, while their mother was at work. Tina’s mom was single. Poor, but no longer on public assistance, at the time Sara worked a minimum wage job at a convenience store to support her family. The only childcare she could afford was an informal arrangement with her next-door neighbor. That neighbor, unfortunately, often left the children with her son so she could run errands. And her son was sick. He tied the children up and raped them, sodomized them with foreign objects, and threatened to kill them if they told. Finally, his mother caught him and put a stop to the abuse.