Book SummaryThe Boy Who Was Raised as a Dog, by Bruce D. Perry and Maia Szalavitz

1-Page Summary1-Page Book Summary of The Boy Who Was Raised as a Dog

In The Boy Who Was Raised as a Dog, child psychiatrist Bruce Perry describes a series of child abuse and neglect cases to illustrate how trauma impacts the developing brain and explain how he and his colleagues established an effective therapy model for traumatized children.

Perry is a psychiatrist and the senior fellow of not-for-profit organization The ChildTrauma Academy. He’s also a professor at the Feinberg School of Medicine in Chicago and co-author (with Oprah Winfrey) of the bestselling book What Happened to You?....

The Boy Who Was Raised as a Dog Summary Understanding Childhood Trauma

Perry defines traumatizing experiences as deeply distressing events such as the loss of a parent or close loved one, witnessing a violent crime, living through an intense accident or disaster, or experiencing neglect or abuse. These events can cause trauma, though they don’t always do so. Whether a distressing event causes trauma depends on many factors, especially the timing of the event and the support the person receives from others.

(Shortform note: Based on the way Perry uses the term, we can infer that “trauma” refers to both the traumatic event and the trauma response (the ongoing reaction to the event). This is also how it’s commonly used in the mental health field. Additionally, trauma may not always come from a specific event: Ongoing stress can also cause a trauma response. This type of prolonged trauma may include experiences like being bullied or feeling powerless, often having to give others news that could traumatize them, [hostile work environments or job...

The Boy Who Was Raised as a Dog Summary The Stress Response

Because of its critical role in the experience of trauma, understanding the body’s natural stress response is essential to understanding all the other principles and cases Perry describes. According to Perry, the most primitive parts of our brain control the stress response, which is a physiological reaction that allows us to respond to threats in our environment. Perry describes two types of stress responses: hyperarousal and dissociation.

Hyperarousal prepares the body to flee or fight a threat by flooding it with chemicals like adrenaline and noradrenaline. Dissociation prepares the body to endure physical harm by slowing its major functions and releasing natural opioids to numb pain. Both of these responses also shut down higher-level brain functions, like abstract thinking and impulse control, in favor of functions that are likely to help us survive the current threat.

This is why traumatized children often struggle with focus: Their brains are constantly on the lookout for threats, which means they’re paying close attention to things like people’s tone of voice and demeanor (which can signal that someone’s about to try to hurt them) and can’t pay attention to...

The Boy Who Was Raised as a Dog Summary Trauma at Later Ages: Associations and the Dissociative Response

These cases demonstrated that stress and trauma in infancy could have long-lasting impacts. Some of Perry’s other cases showed how trauma later in childhood could impact children’s behavior differently. Below, we’ll first explain how the brain stores information, including traumatic experiences. Then we’ll look at the dissociative stress response and how it differs from the hyperarousal response described earlier.

Traumatic Associations: Tina’s Case

Perry explains that the brain stores information in the form of memories and associations. Associations, like those between caregiving and the brain’s reward centers, occur when two neural patterns are activated at the same time again and again, eventually forming a new set of connections between areas of the brain. These connections then help us navigate future experiences that activate the same brain areas. Because these connections become stronger with each use, the connections we form from early experiences—and therefore have used more—are more difficult to change than the ones we acquire later.

To illustrate the role of associations in trauma, Perry describes the case of a young girl named Tina. At the age of seven,...

The Boy Who Was Raised as a Dog Summary Treating Childhood Trauma: Perry’s Neurosequential Model of Therapeutics

The model that Perry developed for psychiatric treatment—the Neurosequential Model of Therapeutics—is founded on the premise that neural development must occur in order, and that if a child misses a developmental milestone due to the effects of their environment (such as abuse, neglect, or other trauma), that milestone can’t be “skipped over.” For example, if a child is not spoken to during their early childhood years, they won’t develop the language skills needed to speak or understand others at the same time other children do, and depending on the extent of the deprivation, they may never develop their language faculties at all.

And, since brain development is cumulative, if a milestone is missed, the functions that build on that milestone won’t develop properly either. The brain will still require a specific type of stimulation to develop that foundational function or region. This means that we can’t treat traumatized children based on their chronological age; rather, we must treat them based on their developmental age.

(Shortform note: The psychological term used to describe the state of someone who hasn’t progressed past a certain point in their development is...

The Boy Who Was Raised as a Dog Summary Implementing the Neurosequential Model: Justin’s Case

We’ll explore a few cases to see how the Neurosequential Model can be applied in the real world. Perry explains that one of the first cases in which he employed his Neurosequential Model was the case of Justin, whose story lent itself to the title of this book.

For the first 11 months of his life, Justin was raised by a loving grandmother, but her death left him in the care of her boyfriend Arthur, who had no child-rearing experience or knowledge. Arthur raised dogs, and because this was the only way he knew to care for another being, he raised Justin in a cage along with them. By age six, Justin couldn’t speak or walk.

(Shortform note: While Justin’s case was important confirmation of the effectiveness of Perry’s model, some reviewers have criticized its use in the book’s title—they see it as a sensationalization of trauma and abuse rather than an accurate description of the book’s content. This generally aligns with widespread criticism of the way the media sensationalizes these topics, which research suggests can [re-traumatize...

Shortform Exercise: Understand Others Through the Lens of Trauma

Trauma isn’t always well understood, especially when it results in behavioral problems or social difficulties. In this exercise, reflect on how people in your life may deal with or exhibit trauma they’ve experienced.

What are the most interesting or unexpected things you’ve learned from this guide about trauma and how it manifests?