Sunday, November 25, 2007

The Boy who was Raised as a Dog by Bruce Perry


I highly recommend the book The Boy Who was Raised as a Dog by Bruce Perry (Basic Books, New York, 2006). (http://www.amazon.com/Boy-Who-Was-Raised-Psychiatrists/dp/0465056520/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1195999799&sr=1-1)
Dr. Perry also has a very helpful web site at: http://www.childtrauma.org/default.asp which contains other articles he has written.

Dr. Perry uses the stories of many abused and neglected children to illustrate and develop his points about the effects of trauma. This book is an excellent way of sharing this knowledge as it is quite readable and fascinating.

Here are some notes I took about points I found important. If you want more information or don’t understand a note- read the book! Or, click “comments” and ask questions.

Brain sets down a “template”- how life is supposed to be and go- and reacts particularly to any thing out side that template, anything new

Thus our early experiences contribute the template: our definition of “normal”

Could also contribute to under-reaction to danger: since brain is particularly paying attention to what is new, what doesn’t fit the pattern- danger is not new

Brain changes through repetitive, patterned activity:
Use dependent development of brain

To change muscle (exercise) must have moderate, repeated, patterned extra stress- brain decides, oh, we are going to be doing this now, better develop some new muscle cells
Same with brain cells
Stress is signal to cortex- something new going on here
Moderate stress is good for brain and body, develops ability to handle stress

However, imagine going to gym and trying to lift 200 pounds- would not build muscle or teach body anything
Would hurt yourself
This is similar to stress children receive from trauma

Brain constantly processing info from senses
Becomes habituated to the familiar
Reacts to the new

Critical to survival to remember those things that led to negative experiences
Often must remember after ONE bad experience
Negative emotions burn events in to memory

Lower brain compares in-coming data with laid down patterns- one question- does this data suggest danger?
Makes immediate response while sending to higher brain for further refinement
Become more alert, look for more information

What the brain does in danger:
1. focused alertness
2. shut down cortex chatter
3. more vigilant and more concrete
4. heart rate increase- blood to limbs
5. focus on social cues- is help available?
6. muscle tone increases
7. hunger/digestion disregarded

Dissociation- freeze- response when you cannot flee or fight
1. curl up
2. make yourself as small as possible
3. prepare for injury:
4. blood shunted away from limbs
5. heart rate slows to reduce blood loss from wounds
6. body flooded with opioids to protect against pain
7. produces feeling of calm and a sense of distance from what is happening
8. some times can help with functioning

Both hyper arousal and dissociation help people survive trauma.
Both can be harmful if prolonged and habituated.

Stress without control is most harmful
Rat experiment- some rats were shocked when they pressed a lever (had control); some were shocked when the other rat pressed a lever (no control): animals who do have control develop strengths, those who do not develop ulcers, lose weight, compromised immune systems, become more sensitized to shock, can’t recover

Stress with control leads to habituation (developing new skills and coping mechanisms)
Stress with lack of control leads to sensitization (disorganized intensifying response, immobility)

Flash backs, re-enactments- an attempt to have small doses of trauma within one’s control to develop habituation or tolerance
If trauma is too much cannot be mastered this way

Brain develops sequentially- certain tasks at certain ages
So traumas at different ages have differing effects depending on what the brain was working on at the time

Terror early in life can shift person to a less thoughtful, more impulsive, more aggressive way of responding to the world- thinking has been shut down too much just when it was time for it to develop

Humans develop through relationships
Relationships necessary for survival
Humans are also our most dangerous predators

Stress responses very closely tied to systems that read and respond to social cues
We are very sensitive to moods, expressions, gestures of others

We have mirror cells in our brains that fire when OTHERS express emotions, creating similar emotions in us
Mother-baby
Basis of empathy
Human society built on this interactivity

Infants born dependent
Parenting is pleasureful
Infant associates touch with pleasure- needs met, relief from distress, calming anxiety
Sensory patterns of human interaction associated with pleasure
Template established
Brain develops in use-dependent manner
If sensitive period is missed, may be hard/impossible to do later- if a kitten’s eye is kept closed during a certain period of sight development, may never develop sight even if opened later
Need repetitive, patterned interactions

If touch has not been associated with pleasure this needs to be addressed in systematic, careful way, starting with less scary touch
Touch own hands
Chair massage
Using heart rate monitor to monitor fear

Importance of rhythms
Rhythm is very important to human functioning
Sleep/wake, when to eat, heart rate, cycles
Use music, movement, dance, drumming to re-train

Using psycho-ed with kids, enables them to help each other

Let me know if you read or have read this book and what your reactions are!

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