Wednesday, October 25, 2017

Love Cannot be Built in Isolation

“The truth is, you cannot love yourself unless you have been loved and are loved. The capacity to love cannot be built in isolation.”
― Bruce D. Perry, The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist's Notebook

“For years mental health professionals taught people that they could be psychologically healthy without social support, that “unless you love yourself, no one else will love you.”…The truth is, you cannot love yourself unless you have been loved and are loved. The capacity to love cannot be built in isolation”
― Bruce D. Perry, The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist's Notebook

“Fire can warm or consume, water can quench or drown, wind can caress or cut. And so it is with human relationships: we can both create and destroy, nurture and terrorize, traumatize and heal each other.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“Relationships matter: the currency for systemic change was trust, and trust comes through forming healthy working relationships. People, not programs, change people.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“The responses of traumatized children are often misinterpreted...Because new situations are inherently stressful, and because youth who have been through trauma often come from homes in which chaos and unpredictability appear "normal" to them, they may respond with fear to what is actually a calm and safe situation. Attempting to take control of what they believe is the inevitable return of chaos, they appear to " provoke" it in order to make things feel more comfortable and predictable. Thus, the "honeymoon" period in foster care will end as the child behaves defiantly and destructively in order to prompt familiar screaming and harsh discipline. Like everyone else, they feel more comfortable with what is "familiar". As one family therapist famously put it, we tend to prefer the "certainty of misery to the misery of uncertainty".”
― Bruce D. Perry, The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist's Notebook

“Biology isn’t just genes playing out some unalterable script. It is sensitive to the world around it,”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“The most traumatic aspects of all disasters involve the shattering of human connections. And this is especially true for children. Being harmed by the people who are supposed to love you, being abandoned by them, being robbed of the one-on-one relationships that allow you to feel safe and valued and to become humane—these are profoundly destructive experiences. Because humans are inescapably social beings, the worst catastrophes that can befall us inevitably involve relational loss. As a result, recovery from trauma and neglect is also all about relationships—rebuilding trust, regaining confidence, returning to a sense of security and reconnecting to love. Of course, medications can help relieve symptoms and talking to a therapist can be incredibly useful. But healing and recovery are impossible—even with the best medications and therapy in the world—without lasting, caring connections to others.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“To develop a self one must exercise choice and learn from the consequences of those choices; if the only thing you are taught is to comply, you have little way of knowing what you like and want.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“We also need to recognize that not all stress is bad, that children require challenges and risk as well as safety. It is natural to want to protect our children, but we need to ask ourselves when the desire for risk-free childhoods has gone too far. The safest playground, after all, would have no swings, no steep slides, no rough surfaces, no trees, no other children—and no fun. Children’s brains are shaped by what they do slowly and repeatedly over time. If they don’t have the chance to practice coping with small risks and dealing with the consequences of those choices, they won’t be well prepared for making larger and far more consequential decisions.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“Memory is what the brain does, how it composes us and allows our past to help determine our future. In no small part memory makes us who we are”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“The core lessons these children have taught me are relevant for us all. Because in order to understand trauma we need to understand memory. In order to appreciate how children heal we need to understand how they learn to love, how they cope with challenge, how stress affects them. And by recognizing the destructive impact that violence and threat can have on the capacity to love and work, we can come to better understand ourselves and to nurture the people in our lives, especially the children.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“Even in utero and after birth, for every moment of every day, our brain is processing the nonstop set of incoming signals from our senses. Sight, sound, touch, smell, taste—all of the raw sensory data that will result in these sensations enter the lower parts of the brain and begin a multistage process of being categorized, compared to previously stored patterns, and ultimately, if necessary, acted upon. In many cases the pattern of incoming signals is so repetitive, so familiar, so safe and the memory template that this pattern matches is so deeply ingrained, that your brain essentially ignores them. This is a form of tolerance called habituation.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“Growth of the Body and the Brain. The physical growth of the human body increases in a roughly linear manner from birth through adolescence. In contrast, the brain’s physical growth follows a different pattern. The most rapid rate of growth takes place in utero, and from birth to age four the brain grows explosively. The brain of the four-year-old is 90 percent adult size! A majority of the physical growth of the brain’s key neural networks takes place during this time. It is a time of great malleability and vulnerability as experiences are actively shaping the organizing brain. This is a time of great opportunity for the developing child: safe, predictable, nurturing and repetitive experiences can help express a full range of genetic potentials. Unfortunately, however, it is also when the organizing brain is most vulnerable to the destructive impact of threat, neglect and trauma.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“When you drive, for example, you rely automatically on your previous experiences with cars and roads; if you had to focus on every aspect of what your senses are taking in, you’d be overwhelmed and would probably crash. As you learn anything, in fact, your brain is constantly checking current experience against stored templates—essentially memory—of previous, similar situations and sensations, asking “Is this new?” and “Is this something I need to attend to?”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“What could prompt parents to give up sleep, sex, friends, personal time and virtually every other pleasure in life to meet the demands of a small, often irritatingly noisy, incontinent, needy being? The secret is that caring for children is, in many ways, indescribably pleasurable. Our brains reward us for interacting with our children, especially infants: their scent, the cooing sounds they make when they are calm, their smooth skin and especially, their faces are designed to fill us with joy. What we call “cuteness” is actually an evolutionary adaptation that helps ensure that parents will care for their children, that babies will get their needs met, and parents will take on this seemingly thankless task with pleasure.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“Surprisingly, it is often when wandering through the emotional carnage left by the worst of humankind that we find the best of humanity as well.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“There were inquiries, Congressional hearings, books, exposés and documentaries. However, despite all this attention, it was still only a few short months before interest in these children dropped away. There were criminal trials, civil trials, lots of sound and fury. All of the systems—CPS, the FBI, the Rangers, our group in Houston—returned, in most ways, to our old models and our ways of doing things. But while little changed in our practice, a lot had changed in our thinking. We learned that some of the most therapeutic experiences do not take place in “therapy,” but in naturally occurring healthy relationships, whether between a professional like myself and a child, between an aunt and a scared little girl, or between a calm Texas Ranger and an excitable boy. The children who did best after the Davidian apocalypse were not those who experienced the least stress or those who participated most enthusiastically in talking with us at the cottage. They were the ones who were released afterwards into the healthiest and most loving worlds, whether it was with family who still believed in the Davidian ways or with loved ones who rejected Koresh entirely. In fact, the research on the most effective treatments to help child trauma victims might be accurately summed up this way: what works best is anything that increases the quality and number of relationships in the child’s life.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“If the experience is familiar and known as safe, the brain’s stress system will not be activated. However, if the incoming information is initially unfamiliar, new or strange, the brain instantly begins a stress response. How extensively these stress systems are activated is related to how threatening the situation appears. It’s important to understand that our default is set at suspicion, not acceptance. At a minimum, when faced with a new and unknown pattern of activity, we become more alert. The brain’s goal at this point is to get more information, to examine the situation and determine just how dangerous it might be. Since humans have always been the deadliest animal encountered by other humans, we closely monitor nonverbal signals of human menace, such as tone of voice, facial expression and body language.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“Our conscious memory is full of gaps, of course, which is actually a good thing. Our brains filter out the ordinary and expected, which is utterly necessary to allow us to function. When you drive, for example, you rely automatically on your previous experiences with cars and roads; if you had to focus on every aspect of what your senses are taking in, you’d be overwhelmed and would probably crash.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“In today’s safety culture we seem to swing from strictly monitoring and guiding our children from infancy through high school, and then releasing them to the absolute freedom of college (though some parents are trying to encroach there as well). We have to remember that for most of human history adolescents took on adult roles earlier and rose admirably to the challenge. Many of the problems we have with teenagers result from failing to adequately challenge their growing brains. While we now know that the brain’s decision-making areas aren’t completely wired until at least their early twenties, it is experience-making decisions that wires them, and it can’t be done without taking some risks. We need to allow children to try and fail. And when they do make the stupid, shortsighted decisions that come from inexperience, we need to let them suffer the results. At the same time we also need to provide balance by not setting policies that will magnify one mistake, like drug use or fighting, into a life-derailing catastrophe. Unfortunately, this is exactly what our current “zero tolerance” policies—that expel children from school for just one rule violation—do.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“As you learn anything, in fact, your brain is constantly checking current experience against stored templates—essentially memory—of previous, similar situations and sensations, asking “Is this new?” and “Is this something I need to attend to?”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“That question became even more salient to me as I began my clinical work with troubled children. I soon found that the vast majority of my patients had lives filled with chaos, neglect and/or violence. Clearly, these children weren’t “bouncing back”—otherwise they wouldn’t have been taken to a child psychiatry clinic! They’d suffered trauma—such as being raped or witnessing murder—that would have had most psychiatrists considering the diagnosis of post-traumatic stress disorder (PTSD), had they been adults with psychiatric problems. And yet these children were being treated as though their histories of trauma were irrelevant, and they’d “coincidentally” developed symptoms, such as depression or attention problems, that often required medication.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“Negative emotions often make things even more memorable than positive ones because recalling things that are threatening—and avoiding those situations in the future if possible—is often critical to survival.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“Of course, the diagnosis of PTSD was only itself introduced into psychiatry in 1980. At first, it was seen as something rare, a condition that only affected a minority of soldiers who had been devastated by combat experiences. But soon the same kinds of symptoms—intrusive thoughts about the traumatic event, flashbacks, disrupted sleep, a sense of unreality, a heightened startle response, extreme anxiety—began to be described in rape survivors, victims of natural disaster and people who’d had or witnessed life-threatening accidents or injuries. Now the condition is believed to affect at least 7 percent of all Americans and most people are familiar with the idea that trauma can have profound and lasting effects. From the horrors of the 9/11 terrorist attacks to the aftermath of Hurricane Katrina, we recognize that catastrophic events can leave indelible marks on the mind.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

“Unfortunately, that basic sense of fairness and goodwill toward others is under threat in a society like ours that increasingly enriches the richest and abandons the rest to the vagaries of global competition. More and more our media and our school systems emphasize material success and the importance of triumphing over others both athletically and in the classroom. More and more, in an atmosphere of increased competitiveness, middle- and upper-class parents seem driven to greater and greater extremes to give their offspring whatever perceived “edge” they can find. This constant emphasis on competition drowns out the lessons of cooperation, empathy and altruism that are critical for human mental health and social cohesion.”
― Bruce D. Perry, The Boy Who Was Raised As a Dog: And Other Stories from a Child Psychiatrist's Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing

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