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)
Perry, Bruce and Szalavitz, Maia. The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist’s Notebook Child Psychiatrist’s Notebook (2007) Basic Books
Dr. Perry also has a very helpful web site at http://www.childtrauma.org which contains other articles he has written and his latest thinking. His model of neurosequential therapy is explained there.
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.
Also, Chapter 11 is about creating the kind of communities that nurture people and help people heal from stress. This chapter forms the basis of Dr. Perry’s upcoming visit to Newtown and his keynote lecture at the Love Wins Professional Conference Dec. 3. (www.anagraceproject.org )
Bruce Perry on the Brain
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.
Our brains set down a template of how life is supposed to be and go- and we react particularly to anything outside that template, anything new.
Thus our early experiences contribute to the template and create our definition of normal.
This could also contribute to a child’s under-reaction to danger: since his brain is particularly paying attention to what is new, what doesn’t fit the pattern- in his life, danger is not new.
The brain changes through repetitive, patterned activity. It is use dependent, meaning that what is used, strengthens.
To change a muscle through exercise we must have moderate, repeated, patterned extra stress- the brain then decides, oh, we are going to be doing this now, better develop some new muscle cells. It is the same with brain cells. Stress is a signal to the cortex- something new going on here. Moderate stress is good for brain and body, develops the ability to handle stress.
However, imagine going to gym and trying to lift 200 pounds- you would not build muscle or teach your body anything. You would hurt yourself. This is similar to the stress children receive from trauma.
The brain is constantly processing information from the senses. It becomes habituated to the familiar. It reacts to the new. It is critical to our survival to remember those things that led to negative experiences. Often we must remember after ONE bad experience. Negative emotions burn events in to memory.
Our lower brain compares in-coming data with laid down patterns and asks one question- does this data suggest danger? It makes an immediate response while sending to higher brain for further refinement. We become more alert, look for more information. Where is the danger? Where is safety?
What the brain does in danger:
1. Focused alertness
2. Shuts down cortex chatter
3. More vigilant and more concrete
4. Heart rate increases- blood to limbs
5. Focuses 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. Sometimes 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 the most harmful. Consider this 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 are an attempt to have small doses of trauma within one’s control to develop habituation or tolerance. If trauma is too much it cannot be mastered this way
Our brain develops sequentially- it has 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 are necessary for survival. Humans are also our most dangerous predators.
Stress responses are very closely tied to systems that read and respond to social cues. We are very sensitive to the moods, expressions, gestures of others.
Mirroring, Relationships and Touch
We have mirror cells in our brains that fire when OTHERS express emotions, creating similar emotions in us. This is the basis of empathy. Human society is built on this interactivity.
Infants are born dependent. Parenting is pleasureful. Infant associates touch with pleasure- needs met, relief from distress, calming anxiety. Sensory patterns of human interaction become associated with pleasure. A template is established. The brain develops in use-dependent manner. If a sensitive period is missed, it may be hard/impossible to do later- if a kitten’s eye is kept closed during a certain period of sight development, it may never develop sight even if opened later. We need repetitive, patterned interactions to heal the brain.
If touch has not been associated with pleasure this needs to be addressed in systematic, careful way, starting with less scary touch. Examples include: touch own hands and chair massage, using heart rate monitor to monitor fear
The importance of rhythms: rhythm is very important to human functioning. Rhythms govern sleep/wake, when to eat, heart rate, cycles. Use music, movement, dance, drumming to re-train rhythms.
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