Bruce Perry, MD is a leading international authority on child psychology and brain development. In a seminar in June of last year, hosted by the Intermountain Children's Home (ICH) in Helena, MT, he discussed the effects of abuse and neglect on early childhood development. He was scheduled to speak at ICH in September of this year to continue the seminar, but unfortunately the event was postponed to January 2006 because Dr. Perry had to remain in Texas to help his program survive the anticipated hurricane.
In his seminars, Dr. Perry makes a strong case that the United States is a "child illiterate society." In the Helena seminar, as well as in other seminars throughout the country, he argues that recent research provides more information about what's good for children than at any other time in our history; yet to the detriment of our children, this knowledge has not yet become part of the common vernacular of the individuals and/or systems who provide care and education for children, nor the professionals who treat them.
By way of illustration, Dr. Perry cites research demonstrating that the typical child allowed unrestricted access to television may witness as many as 200,000 examples of the use of violence as a problem-solving skill by the time he or she graduates from high school. However, most American children continue to spend far more time watching television than engaging in interactive family activities.
Dr. Perry stresses that our biology hones itself to be adaptive to the world as we invent it. However, our brains have evolved to live in a quieter world, with less bombardment. Dr. Perry suggests that the fast-paced world of our recent creation, the world we live in, is biologically disrespectful. In contrast to the slower pace of past generations for which our brains evolved, children and adolescents growing up today are likely to experience greater stress and higher demands than their brain physiology can readily manage. Unfortunately, this overload sometimes translates into emotional or behavioral health issues.
Dr. Perry reminds us that past generations enjoyed larger families with a strong intergenerational presence, greater sense of community, less isolation, more exposure to children and adults of all ages, and more time spent in human interaction. Thus, past generations offered far greater relational opportunities. By contrast, many of today's children grow up in a socio-cultural context of material wealth amidst comparative relational poverty. Perry suggests it is our societal choices and priorities that perpetuate the relational and emotional poverty that in turn produce fewer children who have the capacity to express their human goodness.
Neurobiological research informs us that brain development is use dependent. Meaning that the more a particular neural system is activated, the more the brain changes physiologically to reflect that pattern of activation. Therefore, in order to develop the capacity to be humane, the brain needs to develop within a context of relational enrichment.
Perry explains that "being humane" is not something that randomly pops up in the brain. Rather, it results from repetitive activation of the neuronal systems governing affiliation and relationship during early childhood development. In other words, Perry suggests that it is our earliest attachment relationships that mediate our capacity for "being humane" later in life. This capacity (or lack thereof) becomes neurologically "hard-wired" in early childhood, based largely upon early childhood experiences of relational enrichment versus relational poverty.
Within his role as a neurobiological researcher and scientist, Dr. Perry is a leading contributor to the emerging body of literature that describes abnormal patterns of brain development associated with early abuse, neglect, trauma and relational poverty. Such experiences have a negative effect on brain growth and cause the brain to organize in dysfunctional ways that have lasting effects. For example, if a child is raised in an environment filled with threat, the brain will organize to deal with threat. Such a child will remain hyper-vigilant and have difficulty self-soothing even after the threat is no longer present.
Consistent with his neurobiological perspective regarding the critical role of attachment in early childhood, Perry contends that the most important predictor for a child's recovery in treatment is the quality of the relationships that are formed there.
Perry also teaches a concept critical to success in treatment, which he terms "the neurobiological shackle." That is, you cannot change parts of the brain that are not active at the time of the intervention. For example, the more primitive areas of the brain control many symptoms related to emotional dysregulation. However, talk therapy primarily activates the cortex rather than the primitive areas. It follows that talk therapy alone would not be an effective intervention strategy for an emotionally dysregulated child.
Perry contends that treatment centers and therapists must actively assess which area(s) of the brain are involved when the child struggles with his or her issues, in order to design an intervention strategy that will effectively address both the symptoms and the related neuronal dysfunction. In other words, it is the task of treatment, in part, to facilitate building a better brain.
Another concept critical to the neurobiological treatment perspective is that of sequential development: The most primitive areas of the brain must organize first. If the brainstem is poorly organized, it will disorganize the rest of the brain as well. Perry cites the example that no one would teach an infant to sit up, crawl and then ride a bike. A child unfortunate enough to be presented with such an expectation would likely learn to hate bicycles, feel stupid and incompetent. Perry points out that, sadly, we frequently utilize this kind of mismatching of developmental learning sequences in our schools and in our treatment centers, by attempting to move forward without first addressing areas of developmental deficit. Dr. Perry emphasizes the importance of neurobiological based developmental assessment in order to assure that children do not simply receive "treatment," but treatment made more effective by being sequentially appropriate.
As we left the conference, the general feeling among participants seemed to be that the emerging neurobiological research, such as that described by Dr. Bruce Perry, presents us all with the challenge of re-defining the way we approach parenting, education and children's treatment, now and in the years to come.