The Boy Who Was Raised as a Dog

January 2018

9 min readFeb 6, 2018

Just One Sip — Summary

The Boy Who Was Raised as a Dog is a collection of case studies from a child psychiatrist, Dr. Bruce Perry, who uses his expertise in brain development and neuroscience to study how traumatic experiences shape behavior in children. Each chapter focuses on an individual child’s case, including a child who was raised in a kennel, one who murdered two teenage girls, and another who witnessed her mother get killed. Dr. Perry’s compassion for the children is evident through his insights into their healing process, and readers go on a journey not only with each child but also with Dr. Perry himself as he works to find the most sustainable rehabilitation method for each child.

Why I Chose This Book: Ophelia

My favorite thing about living in the city is volunteering at DrawBridge, a non-profit that provides free art programs for homeless children in San Francisco. Though there are incredibly rewarding moments, there are times when I’ve come home with a sense of helplessness for not being able to relate to or empathize enough with the children I work with. My roommate Nicolle recommended this book after I returned from a particularly challenging session. I wanted to read this book so I could better understand the effects traumatic experiences can have on the development of a child’s brain (and thus, behavior) and ultimately, support the kids at DrawBridge more effectively and empathetically. I knew this book would be a difficult read, so I chose it for book club because I wanted a space for all of us to reflect and digest together.

Discussion Themes & Questions

Empathy

What does it mean to be empathetic to one another? Why is that important?
Is empathy something you turn on and off depending on who you are interacting with or in what context you are interacting?
Are doctors who often have to separate their emotions from the situation at hand (e.g. performing heart surgery on a child patient) exhibiting empathy? How does empathy play a role in the doctor-patient relationship?
Ophelia: This question reminds of neurosurgeon Paul Kalanithi’s experiences in “When Breath Becomes Air,” who writes that the burdens placed upon doctors are “what make medicine holy and wholly impossible: in taking up another’s cross, one must sometimes get crushed by the weight.” I was also reminded of Dr. La Quaglia’s story, featured in the Memorial Sloan Kettering series from Humans of New York. When interviewed, Dr. La Quaglia said, “every time I lose a child, I tell the parents: ‘I’d rather be dead than her.’” Behind the doors of his operating room, he treats every child as his own.

How Technology Has Changed the Way We Interact

In the last chapter, Dr. Perry talks about how the world now is set up in a way that doesn’t allow natural, in-person, “physical” (in the sense of nurturing) relationships to develop.
How much of an effect will our increased reliance on the Internet / social media to connect with others also impact our children’s children’s biological development?
Janelle: For what it’s worth, this issue of technology or the Internet making people more distant from each other can often feel one-sided. Without things like Facetime, Skype, or WeChat, my parents would not be able to see or interact with the rest of their entire family back in China. Without texting or Facebook Messenger, long-distance relationships or even my current relationship probably wouldn’t exist or thrive. And for something like the Facebook Events team that I work on, even though we operate on a platform that is online, our main goal is still to bring people together in real life — to make it that much easier for people to get offline and get together in reality. While technology is often blamed for pushing people further into isolation and into the small devices in their hands, we need to take a step back and remind ourselves that it’s our own behavior and decisions that determines whether technology has a positive or negative effect on our day-to-day lives.

The Boundaries & Ethics of Casework / Journalism

On page 10 in chapter one, Dr. Perry watches a patient’s family wait for the bus in the cold winter, and writes: “I felt guilty watching them from my warm car. I thought I should give them a ride. But the field of psychiatry is very attentive to boundaries.”
If psychiatrists or journalists watch or report on people suffering, should they intervene? (i.e. Kevin Carter and “Starving Child and Vulture”)
Sam: I think the role of the photographer is to promote awareness of this issue. In the long run, I’d argue that the impact of promoting awareness of the issue will be significantly higher than this photographer going out to help with these cases one by one.
JT: I also think people find it much easier to prosecute a single person like Kevin than to actually take action to solve the bigger issue at hand.
Where does the boundary lie between helping people resolve their issues versus taking care of them?
Dr. Perry addresses this moral dilemma and says that “the most impact our clinic can have is to educate more doctors about [their new method of diagnosing and treating children with trauma].”

Additional Comments

Ophelia: I saw a Goodreads review on this book that suggested that writing this book might have been a therapeutic thing for Dr. Perry and the rest of the caseworkers on the team.
Janelle: I wouldn’t be surprised if this was the case — therapists treating themselves with therapy. I wonder how often this happens, in terms of therapists needing time to heal themselves as well?

Final Thoughts

Ophelia

I couldn’t read this book for more than a chapter or two at a time — I needed space and time to digest Dr. Perry’s words. The stories of horror and healing were heartbreaking, insightful and incredibly impactful.

My biggest takeaway was the significance of lasting, nurturing relationships in children’s lives. This excerpt struck a chord with me: “The key characteristic of a relationship that buffers stress is that it is lasting... This cannot be built in a day, viewing people as interchangeable simply creates a repetitive cycle of grief and loss. To break it, we have to stick around.” Strong relationships make all the difference in these childrens’ lives and as Dr. Perry says, “the capacity to love cannot be built in isolation.” Learning about the importance of consistent relationships solidified my desire to volunteer at DrawBridge for as long as I’m in the city.

Another takeway was that there exists “conditions necessary for the development of empathy.” When tragedies strike our country, I always used to think — how could someone do this? I never realized that the conditions some children grow up in are likely, instead, to “produce cruelty and indifference.” The ability to empathize is not something to take for granted.

Sam

Reading about these traumatic incidents is unpleasant, but hearing the stories from the individuals themselves must be on a completely different level. It’s difficult for me to fathom the emotional toll that this job takes on Dr. Perry and I came away from this book with a lot of respect for him and the people who are in his field of work.

As a software engineer, I consider it a luxury that I can compartmentalize by keeping my emotions and work separate. It doesn’t matter how I’m feeling — I know that I can finish what I need to and keep my emotions out of the process. For Dr. Perry, emotion and empathy are at the core of his everyday work. Particularly when working with these children who have been through unimaginable trauma, his ability to quickly identify what the child needs in the healing process is incredible.

“I could see that these parents had spent hours wracked with sadness, confusion and guilt as they searched for the ‘why.’ Why had their son done this? Why had he turned out this way? What did we do wrong? Are we bad parents? Was he born bad? They spoke with total bewilderment about Leon, telling me they’d done their best, worked hard, given him what they could… They struggled to get through every day, tired from their grief, from sleepless nights and from pretending that they didn’t see the stares and disapproving looks from their neighbors and coworkers.”

This passage is one of the most memorable for me. It highlights the neglected other half behind headlines that are appearing too frequently today. Behind every one of these stories, there are parents who are struck wondering what they did wrong for their child to end up like this.

JT

To be frank, I was not prepared for what this book delivered. Dr. Perry weaves together the stories of these children into a profound narrative, and he describes the unthinkable horrors that no person should ever face. It hits hard. Yet, he does not overdramatize, instead lending a pragmatic approach and insight towards child patient-care.

Reading this book, I found that I take the modern approach to psychiatry for granted. Notions that I accept as common-sense were not so. As Perry discusses in his book, it was not even a couple of decades ago that holding therapy was touted as an effective treatment for attachment disorders. Then, and perhaps even now — all sorts of cases that required more care were bucketed as ADHD or epilepsy. Perry demonstrates the complexity of interacting with children that are unable to communicate or understand their trauma, and he illustrates how the doctor can expand beyond the diagnostic manual and treat their patients as humans, not just as aggregates of symptoms.

Dr. Perry illustrates just how indispensable relationships are for healthy child development. There is no substitute. This book has reinforced the appreciation that I’ve had for my own upbringing and will definitely influence the way that I will raise my own future child(ren).

Janelle

When I first opened this book, I honestly didn’t think I’d learn much from it. I don’t currently work in a field that requires knowledge of child psychiatry nor am I anywhere near the stage of my life at which I’ll start thinking about having kids. And even when some of my other friends asked me why I was reading this particular book at the time, I couldn’t give them a straight answer.

But now, I can. I was pleasantly surprised at how themes like empathy and the importance of relationships — ideas that can apply to any person at any stage of life — were so pervasive throughout the book, and from that, I found the following to be what resonated most with me:

Not all people have malicious intent. From Leon’s mother to Justin’s de-facto caretaker after his grandmother died and even (some would say) to the social workers conducting holding therapy sessions in a small Texas town, unfortunate circumstances can happen when people, who just want to help, are not given the resources or taught the skills they need to properly care for other kids, family members, or even themselves.
Relationships (and hugs) matter a lot. Not only do they impact our emotional and mental well-being and stability, but connections with others can also impact us physically and are directly connected to our biological growth. As we saw with what happened to Laura, a lack of a nurturing relationship with a caregiver within the first few weeks let alone months of your life can literally stunt your physical growth.
Fun fact: 85% of your brain develops within the first 3 years of your life, and the brain of a four-year-old is 90% of its adult size.

Word of advice to any potential readers, though: this is not a light read. It’s not a book you can just casually pick up after a long day of work or on a lazy Sunday afternoon. The stories that Dr. Perry talks about are horrific and (sadly) true, so be emotionally prepared before you venture into chapter one and beyond.