The Work of Dr. Bruce Perry: Breaking the Intergenerational Cycle of Trauma

By Suzan Mullane, CEI Faculty

The dark side of childhood trauma—its essence and the healing potential of human relationships—is brilliantly captured in Bruce Perry’s classic work, The Boy Who Was Raised as a Dog (Perry & Szalavitz, 2006). Neuroscience and childhood trauma can be confusing, but Dr. Perry’s case studies are fascinating and easily understood. He presents the developing brain in the context of the human condition—a blend of science and humanity. Narratives on sociopathic behavior and how it develops, for instance, crystallize the reader’s notion that childhood trauma is everyone’s problem. Healthy human relationships can heal emotional wounds and human resilience requires that we, as a society, are intentional about the practice of compassion.

Although teachers are not therapists, they can provide positive nurturing experiences for all the children they encounter. And as Perry points out, a teacher can become a calm, stabilizing factor for children who are living with chaos, anxiety, and fear. When we look at opioid addiction, poverty, abuse, etc. and the far reaching impact these kinds of crises have on children and families, it is hard to imagine how teachers can even begin to help with cognitive and academic growth if basic, underlying issues of security, sense of self, and nurturing classrooms are not a high priority.

The Neurosequential Model of Therapeutics

Dr. Perry’s neurosequential model for childhood trauma, featured in his book, considers the whole system of a child’s life—from birth to current age. Accordingly, social strengths, intellect, school placement, and family dynamics are analyzed. In cases where children experienced grief or loss, Perry notes that “slow and careful” therapy sessions are required. In cases of enormous fear and aggression, Perry explains that clonidine, a medication for anxiety, is sometimes prescribed.

“The Neurosequential Model of Therapeutics maps the neurobiological development of maltreated children. Assessment identifies developmental challenges and relationships which contribute to risk or resiliency. Once identified, trustworthy peers, teachers, and caregivers then combine formal therapy with rich relationships” (The Village Network, 2019).

The neurosequential model, offers the reader a window into the minds of children and the therapists that work with them—a clinical practice beyond traditional Western medicine. Perry was, and is, a pioneer in pediatric neuroscience. His work helps us better understand that when a child is exhibiting social and emotional difficulties, we must take a step back and look at how the brain has been affected by early experiences and what adults can do to help children feel safe again. In many of his sessions with young children, Dr. Perry even lies on the floor and colors pictures as a part of therapy sessions with young children; a practice that conveys a safe and nurturing environment.

Things to Remember When Children Have Emotional or Behavioral Problems

  • Emotional and behavioral problems are often due to abnormalities in the brain and the stress response system.
  • Early experiences have a far greater impact than later ones. Because the brain tries to make sense of things by seeking patterns, it will normalize repeated behavior.
  • Loving attention outside of the family helps children who have been neglected realize that nurturing relationships exist.
  • Many young children of abuse and neglect need physical stimulation. Patterned repeated nurturing can help regulate their stress response system.
  • Developmental trauma happens in the body and impacts the primitive brain stem; hence, patterned, repetitive, rhythmic activities such as walking running, drumming, singing, dancing, and yoga are helpful.
  • To become resilient, children need predictable environments where they feel safe and comfortable. Their sensitized, over reactive stress response systems can gradually become calmer and more regulated over time.

The Tragic Cycle of Unresolved Family Trauma

Commonly, family trauma reverberates across generations. Parenting styles, poverty, and DNA abnormalities in mental health or intellect predispose some children to be labeled, “at-risk.” Labels in and of themselves often do little in the form of treatment for children and youth who have emotional wounds. Pharmacology is not always a quick fix, nor is special education placement. Family pressures that continue to leave caretakers emotionally drained, unregulated, and unsupported may mean that many children remain at-risk.

Parents who neglect children are often desperate, ill-prepared and completely lost when trying to raise an infant. Sometimes, the results are tragic. One of the cases Dr. Perry presents in his book involves 19-year-old Leon, who murdered two 14-year-old girls who refused his advances. Left alone as an infant for hours at a time, Leon’s mother took his older brother to the park and the museum; the older child, Leon’s sibling, was treated by their mother as a, “friend,” of a sort. Abandoned for hours at a time with inconsistent parenting, Leon grew up with little understanding of human relationships, i.e., how to offer comfort, receive empathy, or even give/receive a hug. The part of his brain that stimulates a sense of trust was underdeveloped. Ultimately, Leon committed a heinous crime and went to prison. His victims never had a chance to survive the wrath of a violent sociopath incubated in terror.

A Path to Healing

The Boy Who Was Raised as a Dog also contains stories of hope, including everyday heroes, who have no special training other than a brilliant heart and an ability to distinctively understand childhood maltreatment. For example, “Mama P.” is one such hero— a foster mother, who cradled, rocked, and sang to “her babies.” Knowing what they missed, and needed, she took them back to earlier developmental levels. When others worried that “Mama P.” was infantilizing her foster children, she simply said, “They’re all my babies. I’m giving them what they need and missed” (Perry & Szalavitz, 2006). In “Mama P.’s” care, children felt safe and loved, therefore, they thrived.

Implementing Perry’s Techniques in West Virginia

As a part of my consulting practice in West Virginia, I trained teachers on how to promote emotional regulation through relationships using Perry’s model. The teachers mirrored emotional regulation throughout the day—presenting a sense of calmness and kindness—even as young children, many of whom were being raised in families and communities overwhelmed with opioid addiction, were out of control. When the teachers remained calm and caring, the students felt safe and showed greater on-task behavior.

Other techniques we used in West Virginia increased children’s sense of security by increasing the predictability of daily routines. For example, to help children feel calm during transition times, teachers followed a consistent schedule each day, with detailed picture cues that provided children with visual reminders of the what was happening next. Following, is a listing of other techniques used, for example:

  • Teachers began using calming corners instead of time-out or principal interventions. When teachers would see a “flight, fight, or freeze” behavior, (i.e., signals of stress in the students), the child was quietly invited to go to the calming corner.
  • Coloring books and rocking chairs proved to be wonderful techniques to calm students’ brains through rhythmic patterned movement.
  • In some classes, teachers turned to mindfulness and yoga (Pederson, 2017). The classrooms that received the highest growth on standardized test scores did daily yoga.

My work in West Virginia confirmed what many experts in the area of childhood trauma are saying: The neuroscience of healing offers hope and steels courage. Even in the darkest places of the human spirit, providing safe nurturing environments can help heal pathways in the brain. This seems to be society’s best hope and solution to mitigating our number one health crisis in America—childhood trauma (Anda, 2019). There is hope for victims (and the courageous healers, including educators), who persistently advocate for, work with, and offer valuable supports to vulnerable children.

References

Anda, R. (2019). The Adverse Childhood Experiences study: Child abuse and public health.

Pederson, K. (2017, December 19). The calm corner over time-outs—A new school of thought.

Perry, B. & Szalavitz, M. (2006). The Boy Who Was Raised as a Dog. Philadelphia, PA: Basic Books.

The Village Network. (2019). The Neurosequential Model of Therapeutics.

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