The Boy who was Raised as a Dog

Blog Post by – Steve Tanner

I recently read a book titled The Boy who was Raised as a Dog by Bruce Perry, MD, PhD and Maia Szalavitz (2006, 2017). I read the 2017 edition which includes answers to frequently asked questions since the 2006 edition was first printed. It also includes questions and answers that can be used for study groups.  Maia Szalavitz is “a science writer and reporter” who recorded conversations with Dr. Perry and transcribed those recordings into this book.  You can find this book at https://pathwaystointegration.com/must-reads/ .

Bruce Perry is a child psychiatrist who works with traumatized children at the ChildTrauma Academy in Houston, Texas. He has worked with the group of children who were fortunately released from the Branch Davidian compound in Waco, Texas. They were bathed in fear from birth. He worked with teen-age girls rescued from the FLDS church of Warren Jeffs who were included in polygamist marriages to older men in that sect. He has worked for many years with children in the child protection services (CPS) system, who were victims of every form of abuse . He has worked with young children who were witnesses to violent murders. He worked with children from one town who were placed in CPS amidst fears of Satanic child sacrifices. While in CPS caretakers tried to cast demons out of them. He has worked with children who were left in their cribs 8-12 hours each day for the first 18 months to 3 years of life out of ignorance or institutionally in a Russian orphanage. He worked with a young boy who was left in the care of dog trainer by his dying grandmother. The dog trainer, who had subnormal intelligence, didn’t know how to care for him, and so, made him stay in a kennel like his other dogs for many hours each day – thus the title of the book. Needless to say that Dr. Perry is experienced in how traumatic injury and neglect effect the developing brain. His work is becoming more widely known. For example, he has appeared and collaborated with Oprah Winfrey. 

It is through these experiences that his method and understanding of trauma treatment developed known as the Neurosequential Model of Therapy (NMT) . Dr. Perry did not start out to prove the Neurosequential model, rather NMT is the fruit of years of experience working with traumatized, abused and neglected children. NMT assumes that our brains are the product of human evolution containing the brain stem, the lower brain, limbic brain and higher brain (cortex) structures. The evolution of the human brain is sequential from low to high with each new layer adding complexity of function. Not only does the human brain contain the evolutionary sequence of brain structures, but individual brain development follows the same sequence.  Even while still in the womb our brains are being shaped by experience. As we experience our world connections among brain cells are being made and cut.  In order for our brains to develop normally we need to experience loving touches from our caretakers. We need to hear loving, prosodic voices and have positive and loving social interaction.  Without any of these we miss key stages of brain development in certain brain structures. 

Perhaps the main theme of Dr. Perry’s book is that knowing when trauma, abuse or neglect occurred is just as important as understanding what kind of insult the child experienced. Early trauma and neglect will result in the lower parts of the brain not developing normally or fully. Thus, later brain growth will suffer from the lack of function in the earlier sequence of brain development. So as a model of therapy, on an individual basis, NMT tries to understand what parts of the brain were impacted by trauma or neglect and then begins therapeutic treatment at the lowest level and attempts to progress up the sequence. The goal is to help the lower parts of the brain make the kinds of positive connections that should have been made at an earlier stage, and by consequence, help later brain development improve as well. Hence the name Neurosequential Model of Therapy.  Again, NMT is not only interested in what kind of abuse, trauma or neglect happened, but when it happened as well. NMT believes that the experiential development of the human brain follows the path of its human evolution, and effective therapy follows the same trajectory.

Another major theme of NMT is that we humans are social animals. Our brains need social stimulation. Without positive social interaction we will not thrive and our brains will not fully form. Children who have experienced abuse and neglect may be constantly scanning for negative social cues or perhaps not even understand social cues at all.  Not only will brain development be impacted but body growth will be impeded as well. It is now known since the first ACE (adverse childhood experience) studies (performed by the CDC and Kaiser Hospital network in San Diego 1995-1997) that stress caused by trauma, abuse and neglect impede the physical growth of children and leave them more susceptible to develop disease later in life. Social relationships are significant in this study.  Dr. Perry remarks that “the most important healing experiences in the lives of traumatized children do not occur in therapy itself”(p.259)  but rather healing is found in loving community and relationships. Again, “Relationships are the agents of change and the most powerful therapy is human love” (p. 258).

Therapeutic Principles of NMT

Some of the therapeutic principles described in this book are as follows:

  1. Early trauma, abuse and/or neglect impact lower brain development which consequently effects later brain development.  Therapy should focus on providing experiences those brain regions in these cases. If the trauma, abuse or neglect happens later in a child’s life, then therapy should focus on the age appropriate area(s) of that child. 
  2. The nervous system gets sensitized or attuned to trauma and abuse. Novel traumatic experiences may invoke over-sensitized responses.
  3. Consistent, patterned and repetitive therapy is needed to treat childhood trauma. Dr. Perry add, “The longer the period of trauma, or the more extreme the trauma, the greater the number of repetitions needed to regain balance” (p. 275).  
  4. Recovery eventually requires revisiting the trauma, abuse or neglect.  When the time is appropriate this should be done in “doses”.  The patient should be in control of how frequently and how deeply they choose to revisit the trauma in the therapeutic relationship.  The patient chooses the timing and the depth of the visit.  Therapy always yields to the child’s sense of safety and comfort. 
  5. Resilience is built in therapeutic relationships that are predictable, controllable and that work in moderation. 
  6. The best therapy happens outside the clinic is loving relationships and community. 

NMT and Neurosculpting® Meditation

As I read The Boy who was Raised as a Dog some parallels between Neurosculpting® and NMT occurred to me.  Here are a few of my reflections: 

  1. The structure of a Neurosculpting® meditation follows the same trajectory as Perry’s Neurosequential model. Neurosculpting® meditations begin with a two step induction.  That is, Neurosculpting® meditations begin with relaxed, patterned breathing meant to stimulate parasympathetic relaxation and bring balance to the lower brain. The second part of the induction focuses on creating a sense of safety and comfort to the meditator.  And as the meditation proceeds emphasis is placed how the meditation is under the control of the client. They can choose to make it whatever they choose. They can explore in the meditation however deeply they wish. 
  2. The goal of the induction is to minimize sympathetic arousal and the limbic brain so that the meditator can access the higher brain and enhance their meditation with rich imagery and language.  It is understood that when the limbic brain in a state of alert that resources such as oxygen and blood sugar are not shared proportionally to the higher brain. The limbic brain is the main consumer. 
  3. Some meditators may use only the induction for a long time. It may be too great a challenge to feel safe enough to proceed into revisiting memories of trauma, abuse and neglect.  It may take time for people to have a sense of control before moving deeper into these stories. 
  4. Repetition is key for renegotiating past experiences and memories. We know that the vehicles of neurosplasticity are repetition and novel experiences.  Neurosculpting® meditation promotes positive neuroplasticity.  Repeated meditation is an effective strategy for renegotiating traumatic memories and stories. 
  5. Neurosculpting® is very interested to helping people to regulate and calm down sympathetic arousal and bring it into balance with the parasympathetic system. Neurosculpting® facilitators are taught some somatic “hacks” to help people do this such as blowing raspberries, bodily shaking, breathing, bodily movement and dance.  Some Neurosculpting® facilitators have learned other modalities such as TRE® (Tension & Trauma Releasing Exercises) as a somatic means to help people release tension and trauma from their bodies. Also some Neurosculpting® facilitators practice other modalities such as yoga, massage therapy and dance in order to help clients to simply feel at home in their bodies. Dr. Perry recommends massage therapy for children who have suffered neglect in order to stimulate the brains areas that did not develop when they should have.  This cannot fully restore early brain development but Dr. Perry and the ChildTrauma Academy have found that massage has some positive effect.
  6. At the Neurosculpting® Institute facilitators learn about how social engagement can regulate or dysregulate the human nervous system. Facilitators are taught David Rock’s SCARF model and are exposed to the Polyvagal Theory by Stephen Porges. Dr. Perry says in numerous places in this book that we “social animals”.  While he does not mention Polyvagal Theory at all, Dr. Perry is very aware of how we co-regulate or dysregulate each other.  He mentions mirror neurons throughout the book and explains how and when to make eye contact with traumatized and abused children. 

In summary, The Boy Raised who was Raised as a Dog offers a wealth of information about trauma and trauma therapy. It is also a deeply insightful and sensitive read about human psychology and development. There is wealth of tips and information about how to understand and interact with children (and people) who have suffered long term, abuse or neglect. He also offers insight into how long term racial discrimination can sensitize sympathetic responses just as big ’T’ traumatic events such as war, or an accident of some kind. It is interesting to read the parallels between information and insights found in this book confirm the basic assertions of Neurosculpting® meditation. 

Steve Tanner lives near Boise, Idaho and has been a Certified Neurosculpting® Facilitator (CNF) since 2018. He is also a Certified TRE® Provider since 2019. He loves camping, writing and have conversations about human consciousness. You can contact him at integrationforlife@gmail.com or through PathwaysToIntegration.com.