Ramblings and a Book Review
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. By Bruce D. Perry, M.D., Ph.D and Maia Szalavitz.
Holistic Psychiatry
This was a fantastic book about what we can learn from maltreated, abused, and neglected children. But more than that, this book illustrates the journey of a psychiatric fellowship from reductionistic, diagnosed-based thinking to holistic thinking and treatment strategies.
In the beginning of his career in child psychiatry and research, Dr Perry struggles to find a way to help the children coming to him for help. He talks in great length about the limitations within the system and in the training of the time. He didn’t feel the children in his care fit standard diagnostic criteria, as it was based on symptoms rather than environmental or historic influences.
Luckily, he had mentors on both sides of the fence. One was very much entrenched in the modern medical view of diagnosis and protocol-oriented treatment options, while the other had a more flexible and encouraging approach. I love the way he struggled to find the best treatment methods to help each person in his care.
As he grew as a clinician, Perry began to truly understand that how a person presents in the moment reflects their personal and developmental past. Over time, he and his fellows began to look at the whole person, rather than just the symptoms. They stopped diagnosing or “labeling” people and began to “map” the functional development of each individual. To accomplish this, they looked at the history of each person and not just behavioral or interventional histories. They looked at physical, mental, emotional, and developmental backgrounds. They talked to doctors, teachers, parents, and other people involved with each child with the goal of putting together a picture of that person and what was going on.
Moving toward a holistic approach
This is HUGE! Dr Perry and his fellows at the Child Trauma Academy started teaching holistic psychiatry and mental health treatment for abused, maltreated, and neglected children to academics and medical professionals in 1998. When I left the mental health and vocational rehabilitation system in 1997, the system was still very entrenched in diagnostic labeling. At that time there was talk of moving beyond labeling, but most everyone still had a habit of regarding someone as their diagnosis.
This kind of behavior makes a person feel smaller. It focuses on challenges and illness, rather than strengths and possibilities. Many years later, when my mom was hospitalized for hip-replacement surgery, I heard one of the nurses refer to her as a “hip.” I was taken aback. We are, each of us, more than our challenges of the moment. Honestly, I had thought we had grown farther in so many years. Still it’s heartening to see an influential institution of medical-based mental health embracing a holistic, individualized approach. Even more encouraging is that many social workers, justice professionals, mental health professionals and more are moving fluidly toward holistic ideas.
How this relates to holistic practitioners
Holistic health practitioners, like herbalists and yoga therapists, have long understood that better results are possible when we look at, and treat the whole person. When only the symptom is treated, whatever caused that symptom will likely find a new outlet, thereby causing a new, seemingly unrelated problem. When we take a good history and look at a full picture of each person, we can offer solutions that not only resolve the presenting problem but bring the person to homeostasis, or the most optimal level of functioning. The human body is an incredible and intelligent biological machine, always seeking harmony. That means that no matter what symptoms or level of health any person is experiencing, it is the result of the body compensating or overcompensating for something going on. When we bring resolution to the underlying issues, things settle down and as if by magic, we feel better. By building strengths, building healthy relationships, and offering pleasurable, do-able options, people begin to make progress.
Even though Dr Perry teaches from the lens of child psychiatry, we can all see how his ideas resonate with our own personal disciplines and areas of expertise. I personally see all of this through the lens or Yoga Therapy. I am not a mental health professional; I am a holistic practitioner. As such, I feel Yoga Therapy is well suited, as a complementary treatment, for people who have experienced trauma, and adversity in general, be they adult or child.
Some key concepts discussed in the book and how they relate to yoga and yoga therapy.
Perry
- It is the therapeutic relationship more than the therapy itself that seems to make the most difference for people. The relationship should be stable, respectful, supportive, and consistent.
- The patient needs to agree to and feel in control of the therapy. Interactions need to be safe, predictable, and pleasurable.
- Patterned, repetitive, experience is required to produce long-term changes in the brain and behavior.
- Dr Perry warns readers about the dangers of acting on “a little learning.” No one is an expert after reading one or even many books. It takes years of experience and training in one’s chosen field for effective and confident action.
- To help another person regulate their feelings and behavior, we must be able to regulate our own.
Yoga Therapy
- In the lineage of TKV Desikachar, we feel that true change comes through the relationship with the teacher. When we have a positive, healing relationship with our teacher (or yoga therapist,) we have faith that the practices they give us will help. We let ourselves be at ease. When at ease, mirror neurons can go to work, sharing the energy of the teacher with the student. We believe in long-term, consistent, teacher-student relationships, most lasting for many years.
- In Yoga and Yoga Therapy, we believe that best results happen when the student, or client, leads interactions. That means, they are in control of practices and therapies, or treatments. Yoga therapists meet each student where they are, creating a safe, respectful, and supportive space.
- Yoga practices and interactions, whether private, one on one, or group classes, are patterned and predictable. We believe that doing the same practice every day for some time (from 6 months to years,) creates new patterns of thoughts and behavior.
- In Yoga and Yoga Therapy, we have the philosophy, “Dig one well deep.” Staying with one practice, teacher, path, or therapy brings a deeper understanding and better results. Whereas jumping from subject to subject, gives only a shallow perspective and little practical use. Whatever the discipline, stick with it.
- In yoga we have the idea of an acharya. An acharya is a yogi who, after practicing and studying for some time, teaches what they have come to embody or understand, hopefully transforming our difficulties and becoming more comfortable with ourselves before teaching others.
Yoga is one of many holistic paths to personal health and transformation. An ancient path, yoga gives us concrete tools that affect us on all levels, mental, emotional, physical, and spiritual. Each person is honored as unique. Each path is a little different. As we move down and within, our health improves, we become more self-regulated, we become more comfortable with ourselves in our own bodies and most importantly our relationships improve.
Part of the Team
Like Dr Perry’s warnings of acting with “a little learning,” the wrong practice can do damage. Yoga therapists are not mental health professionals. Most will work best as part of an interdisciplinary team, especially working with mentally challenged or traumatized individuals. However, I do believe Yoga Therapy can be a valuable part of the team. Having a positive impact in the lives of individual people.
There are many studies that show the positive impact of yoga for a variety of populations. I’m not going to go into them here. I simply want to thank Dr Perry for his wonderful work. The Boy Who Was Raised as a Dog, was insightful, honest, and hopeful about the ways developmental and environmental influences effect our lives and what kinds of therapies may be of most benefit. Thank you for your hard work.
Many blessings
Annie Jones