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Was it treatment—from us and all of the other clinicians before us—that made the difference? Was it important that his family pushed for intervention when he was young? Did it matter that we were able to intervene early in Connor's adolescence? Probably. But did any of that truly count in keeping him from becoming a raging sociopath like Leon? It is, of course, impossible to know. However, in our work with children like these two very different boys who experienced severe early neglect, we have found a number of factors that clearly do play a role in which path they follow, and we try to address as many of them as possible in our treatment.
A number of genetically influenced factors matter. Temperament, which is affected by genetics and intrauterine environment (influenced by maternal heart rate, nutrition, hormone levels, and drugs) is one. As noted previously, children whose stress response systems are naturally better regulated from birth are easier babies, so their parents are less likely to get frustrated with them and abuse or neglect them.
Intelligence is another critical factor, one that is often poorly understood. Intelligence is basically faster information processing: a person requires fewer repetitions of an experience to make an association. This property of intelligence appears to be largely genetically determined. Being able to learn with fewer repetitions means that brighter children can, in essence, do more with less. Hypothetically, for example, if it takes a normal child 800 repetitions of having his mother feed him when he is hungry in order for him to learn that she will come and help modulate his distress, it might take only 400 repetitions for a “smarter” child to make the connection.
While this doesn't mean that smart children need less affection, it does suggest that if they are deprived, brighter kids may be better
equipped to cope. Needing fewer repetitions to build an association may allow smarter kids to more quickly connect people with love and pleasure, even when they don't receive what is usually the bare minimum of stimulation required to cement those links. This quality might also allow them to benefit more from brief experiences of loving attention outside the family, which can often help severely abused and neglected children recognize that the way it is at home is not necessarily the way it is everywhere, a realization that can offer them much-needed hope.
Intelligence may also help protect young people in other ways from developing the kind of rage and sociopathy we saw in Leon. For one, it allows them to be more creative when making decisions, giving them more options and decreasing the likelihood they'll make bad choices. This also helps them avoid a defeatist attitude, thinking “there's nothing else I can do.” Being able to envision alternate scenarios may also help increase impulse control. If you can think of a better future, you may be more likely to plan for it. And being better able to project yourself into the future may also improve your ability to empathize with others. If you're planning for consequences, in some sense, you are empathizing with your “future self.” Imagining yourself in another setting is not a far leap from imagining the perspective of others—in other words, empathizing. However, intelligence alone is probably not enough to keep a child on the right track, however. Leon, for example, tested above average in some areas. But it does seem to help.
Another factor is the timing of the trauma: the earlier it starts, the more difficult it is to treat and the greater the damage is likely to be. Justin had nearly a year of loving and nurturing care before he was placed in that dog cage. That affection built the basics of so many important functions—including empathy—into his brain and, I believe, greatly aided his later recovery.
But perhaps the most important factor in determining how these children fare is the social environment in which the child is raised. When Maria and Alan lived among their extended families, other relatives were able to make up for Maria's limitations, and Frank had a normal, happy
childhood. Leon's neglect occurred only when Maria no longer had a supportive social network to help her cope with parenting. In Connor's case, while his parents had more financial resources, they were stymied by a lack of information about child development. Better knowledge would have allowed them to recognize his problems much sooner.
In the last fifteen years numerous nonprofit organizations and government agencies have focused on the importance of education about appropriate parenting and early childhood development, and on just how much critical brain development goes on in the first few years of life. From Hillary Clinton's “It Takes a Village” to Rob Reiner's “I Am Your Child” Foundation to the Zero to Three organization and the United Way's “Success by Six,” millions of dollars have been spent to educate the public about the needs of young children. The hope of these efforts—some of which I have been involved with—is to make this kind of neglect far less likely to occur due to ignorance. I believe they have had a significant impact. However, the age segregation in our society, the lack of integration of these key concepts into public education and the limited experience many people have with young children before they have their own still puts far too many parents and their children at risk.
Currently, there's little we can do to change a child's genes, temperament or brain processing speed, but we can make a difference in their caregiving and social environment. Many of the traumatized children I've worked with who have made progress report having had contact with at least one supportive adult: a teacher who took a special interest in them, a neighbor, an aunt, even a school bus driver. In Justin's case, his grandmother's early kindness and love allowed his brain to develop a latent capacity for affection that unfurled when he was removed from his later deprived situation. Even the smallest gesture can sometimes make the difference to a child whose brain is hungry for affection.
Our work using the neurosequential approach with adolescents like Connor also suggests that therapy can mitigate the damage done by early neglect. Affectionate touch, appropriate to the developmental age at which the harm was done, can be given through massage therapy, and
then repeated at home in order to strengthen the desired associations. Rhythm keeping can be taught through music and movement classes, which can not only help a dysregulated brainstem to improve its control over important motor activities like walking, but also, we think, strengthen its role in stress response system regulation. Socialization can be improved by starting with teaching simpler, rule-based, one-on-one relationships and then moving to more complex peer group challenges.
I believe if Leon's maternal neglect had been discovered earlier, there is a good chance that he would not have turned out the way he did. It took a long chain of deprivation of developmentally necessary stimuli and poor responses to Leon's needs and bad choices by Leon himself for him to become a vicious killer. At any one of these crossroads, particularly those at the beginning of his life, a change in direction could potentially have led to a completely different outcome. If we had been able to treat him as a young adolescent, like Connor or, better still, during the elementary school years, like Justin, I think his future could have been altered. Had someone intervened when he was still a toddler he would have become a completely different person, far more like his brother than the predatory young man I met in the prison cell.
Because trauma—including that caused by neglect, whether deliberate or inadvertent—causes an overload of the stress response systems, which is marked by a loss of control, treatment for traumatized children must start by creating an atmosphere of safety. This is done most easily and effectively in the context of a predictable, respectful relationship. From this nurturing “home base,” maltreated children can begin to create a sense of competence and mastery. To recover they must feel safe and in control. Consequently, the last thing you want to do is force treatment on these children or use any kind of coercive tactics.
The next chapter illustrates some of the harm coercive methods can cause.
chapter 7
Satanic Panic
“I DON'T DO SATAN,” I told the eager young man from the Texas governor's office. He was trying to enlist my help with a complex case involving a group of children who reportedly had been ritually abused by members of a Satanic cult. The boys and girls were in foster care at this point, safe from their supposedly devil-worshipping parents and their coven of friends, but the state attorney general's office had become worried that local child protective services workers had taken these children out of Beelzebub's frying pan and into hell on earth.
 
IT WAS LATE 1993. I had been trying to stay out of the contentious “memory wars” then raging over whether previously unrecalled incidents of severe abuse “remembered” by adults during therapy were true. There was also debate about whether children's accounts of recent abuse or molestation were accurate. I knew for sure that there was an awful lot of genuine child abuse going on: every day I saw wrenching, concrete evidence of it.
But I also knew from my training in neuroscience and my clinical work with traumatized children that narrative memory is not simply a videotape of experiences that can be replayed with photographic accuracy. We make memories, but memories make us, too, and it is a dynamic, constantly changing process subject to bias and influence from many sources other than the actual event we are “storing.” What we experience
first filters what comes afterwards—just as Tina's early sexual abuse shaped her perception of men and Leon and Connor's neglect altered their respective worldviews. However, this process works both ways: what we feel now can also influence how we look back and what we recall from the past. As a result, what we remember can shift with our emotional state or mood. For example, if we are depressed we tend to filter all our recollections through the haze of our sadness.
We know today that, just like when you open a Microsoft Word file on your computer, when you retrieve a memory from where it is stored in the brain, you automatically open it to “edit.” You may not be aware that your current mood and environment can influence the emotional tone of your recall, your interpretation of events and even your beliefs about which events actually took place. But when you “save” the memory again and place it back into storage, you can inadvertently modify it. When you discuss your memory of an experience, the interpretation you hear from a friend, family member, or a therapist can bias how and what you recall the next time you pull up that “file.” Over time, incremental changes can even lead to the creation of memories that did not take place. In the lab, researchers have been able to encourage test subjects to create memories of childhood events that didn't happen: some as common as being lost in a mall, others as extreme as seeing someone possessed by a demon.
Back in 1993, however, the nature of memory and its incredible malleability weren't as well researched and what was known about traumatic memory had not been widely taught to clinicians or other professionals working with children. Survivors of incest were bravely speaking out about their experience for the first time and no one wanted to question their stories or the reality of their pain. Children's claims of being abused were also being taken much more seriously than they had been in the past. People didn't want to go back to the bad old days when abusive adults could count on a child's accounts of mistreatment being met with disbelief. Unfortunately, this desire to give the benefit of the doubt to victims, the naïveté of some therapists and their ignorance of how coercion can affect memory combined to cause serious harm.
Perhaps nowhere was that more evident than in the Satanic panic that swept Gilmer, Texas, in the early 1990s. The governor's aide explained to me what he knew of the situation.
A seven-year-old boy, Bobby Vernon, Jr., was lying in a hospital in an irreversible coma, having been pushed down a flight of stairs by his recently adoptive father. Both this adoptive father and his wife had then committed suicide after their other adopted and foster children were taken away following Bobby's hospitalization; the father by shooting himself in the head the next day and the mother by an overdose a day after that.
The seven-year-old's skull had been fractured and he had severe brain damage. Little Bobby had refused to continue running up and down the stairs, which he had been being forced to do by his “parents.” According to siblings who witnessed the assault, either one or both of the adults had smashed his head on a wooden floor until the back of his head “was mushy.” To make matters worse, when the adults finally stopped the beating long enough to realize that the boy was unconscious, instead of immediately calling 911 they waited for an hour to get help, trying bizarre things like spraying Windex in the child's face in an unsuccessful attempt to revive him.
EMS (Emergency Medical Services) workers were appalled by how these foster/adoptive parents appeared to be disciplining the ten children in their care. The children described being starved, isolated and repeatedly beaten. The paramedics told the parents, James and Marie Lappe, that they were required to call Child Protective Services (CPS), whereupon they were informed that the couple was actually employed by CPS. Theirs was a “therapeutic” foster home. The children, according to the Lappes, had been victims of Satanic Ritual Abuse (SRA) by their parents; what looked like harsh discipline was actually “therapy” for these children. Surprisingly, the family's CPS caseworkers in east Texas backed them up, insisting that the children had been in good hands at the Lappe home. The Lappes, however, were no longer in east Texas. They had moved to a west Texas community “in secret” to get away from what they
believed was an active and dangerous Satanic cult, which wanted its children back and was prepared to do anything to get them. The local CPS workers in west Texas knew nothing about this “therapeutic” home in their community nor about this alleged cult. It was at this point that higher-level state CPS officials were notified about the situation.
BOOK: The Boy Who Was Raised as a Dog
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