Perry Chapter 2

“For your own good, dude.” How casual of a phrase this is, paired with the action being committed was really jarring. This is a phrase friends say to each other when there’s gnarly breakup, or the loss of an unhealthy item. Reading this chapter created a lot of cognitive dissonance around this. What had the mother done? Why did she have a mark on her? How can you be so casual while trying to murder a child? How do you get two slits on your throat, and not die? Much less go attempt to drink milk?! How do you fuck up slitting someones’ throat twice, to where they are still alive?

                Dr.Perry talks about dissociation and how that caused Tina to survive. Dissociation as a physical survival method supported biologically made only a bit of sense to me. While I have seen many kids dissociate while working with them, I had only gotten to the point of “fight , flight,or freeze”. While Tina was in freeze, it didn’t occur to me that her blood flow was less, and focused away from critical parts of her body. The shutting down of pain caused by dissociation I suppose could account for her trying to drink milk only to realize it was coming out of her throat.

                I was happy to see Dr.Perry utilizing medication more, and finding new ways to help the boys at the residential center he was at. I think it’s also great that he advocated his use for the medication. The amount of diagnoses these children are given as opposed to PTSD is astonishing. I wonder if this is just because it’s ahrder to diagnose PTSD due to kids’ limited communication? It infuriates me that Tina’s case worker thinks that after all she went through, she doesn’t need to see a mental health professional. The comments made about resiliency were also shocking. “Oh yeah kids are resilient. They can see this stuff.” In what world?! With their brains still developing, the stress becomes ingrained and then impairs the brain function. Then as they grow it stays there until it is able to be processed out.

                I really loved that Dr.Perry was so aware of how he was being perceived by Tina and did what he could to be less intimidating and meet her at her level.   He did not try to rush the process other than by asking what happened to her neck.  I found the information on tolerance and sensitization to be interesting. I had only ever considered tolerance when thinking about drug habits. Sensitization makes sense in terms of trauma response and overdosing. Habituation being interrupted by negative emotion, and becoming sensitized is also a phenomenon that I am familiar with. The constant comparison of past patterns to what is currently happening is a very real thing for someone who suffers from anxiety. Tina was most likely comparing each thing that is occurring to the past, which I’m sure causes triggers for her PTSD.

Perry Chap 1

So I started this book emotionally guarded, due to the amount of sadness our professor had mentioned in class. I was genuinely curious to hear about Dr.Perry's first client. I was rather surprised and upset that he somehow didn't know what the child was doing when she climbed into his lap. When I worked at the in patient home for children who had severe behavioral and emotional difficulties, that was one of the first things addressed in training...boundaries. We were instructed to not immediately give children physical comfort (hugs, back rubs, holding their hand etc.) due to many of the children being groomed from sexual abuse. I can fully agree that the child is not consciously making the decision all the time to act the way he/she does. The patterns that the brain finds and sees, wear down a familiar track that the child definitely follows along.

While my former work place functioned behind TBRI (Trust Based Relational Intervention), it did not teach about a lot of the neurological pieces Perry delves into. If it was mentioned, it was very basic. I was familiarized very well with the brain stem having the "fight or flight" response. I would have loved to have known how he planned to address each dysfunctional behavior by treating the portion of the brain that it stemmed from.

It did worry me that after 3 years of working with the child, she relapsed on her behavior. I think of my work with children who had similar issues. I worry about them relapsing as well. It was comforting to think of how he only spent an hour a week with this girl, whereas the children had 24 hours, 7 days a week of therapeutic intervention. Dr. Perry also seemed very opposed to medicine. I both agree and disagree with how he handled the situation in regards to this.

On one hand, I believe that children are way over medicated in today’s world, and that it is important for children to learn how to cope etc without the help of certain types of medication. However, medication can also help with certain symptoms so that the main problem can be addressed easier. I do wonder if he had prescribed medication for his client, if her impulsivity could have been buffered, and her relapse have been potentially avoided.

I empathized with Perry wanting to give the family a ride home. I worked with individuals who were experiencing homelessness during my first field, and would find myself wanting to give them rides places (social security office, food stamp office, VA, a potential housing opportunity, etc). I discussed this with my supervisor on a few occasions, and it was determined to be outside of my role. I was very surprised that he did not receive any disciplinary action. While I understand it was for the benefit of the client, it crossed some boundaries of professionalism. I’m glad it broke the resistance with the mom, but I would be interested in other ways to break the parental resistance. I would be interested in the work Dr. Perry did with the mother to help break down the stress hormones at home.