Bruce Perry’s Chapter 4 of The Boy
Who Was Raised As A Dog, Skin Hunger, depicts the story of Laura and Virginia,
a mother and daughter duo who both struggled with attachment trauma associated
with Virginia’s past history moving from home to home within the foster care
system. My first reaction as I was
reading this chapter was anger and frustration due to the marveling that took
place from all of the medical professionals that Laura encountered. For the first four years of her life, she was
subjected to unnecessary medical procedures all in the name of looking for
something facsinating. Beginning at the
age of infancy, the child who was already experiencing neglect (although not
with ill intention) from her mother, was used as a stepping stone of curiosity
and career fufillment by those who were supposed to be protecting her. Due to this, Laura endured trauma after
trauma with each medical procedure at the hands of medical professionals
looking to get an edge up in their careers.
With all of this being said, as
someone who is extremely interested in how the healthcare system impacts
clients, I am optimistic that many more clinicians seem to be paying attention to
trauma now and how it impacts patients on both mental and physical levels. Today, there is so much research being conducted,
and trainings being provided to help alleviate situations from escalating to
the degree that Laura experienced the medical system. I have encountered many medical professionals
who are now being trained (or have been trained), in how to appropriately
assess for trauma and also have more of a working relationship with the topic
of mental health and mental health practitioners. Additionally, skills (such as Motivational
Interviewing) are being implemented to provide non-judgmental, patient centered
treatment.
I found Bruce Perry’s interaction
with Mama P. particularly uplifting as he modeled patient-centered care to
those who were learning from him. He
explored his needed areas of improvement and recognized how his interactions could
change with Mama P. He then allowed her
to be the expert of her own experiences working with the children that she
cared for and was able to learn from her.
In doing this, he modeled a basic concept for his student and readers:
building rapport. He allowed himself to
climb off of the expert pedestal and build a working relationship that included
trust, compassion and empathy. This, in
turn, became a valuable tool because it created a space in which he could provide
what his client needed in a much more timely fashion.
Hi Taylor!
ReplyDeleteI was equally as frustrated by the extensive medial procedures that Laura underwent. It feels so inhumane and unethical so it was difficult for me to try and empathize with the medical professionals since they, too, wanted to help Laura. I was really happy that Dr. Perry could step in. I can't remember if Perry specifically identified Laura's medical journey as trauma but that make sa lot of sense! Laura was denied a seemingly "normal" upbringing and was more often than not in the company of strangers and in strange settings.
I agree that trauma is now a bigger part of the conversation in the health care industry. Thank goodness. I feel like this is because of the increasing efforts to destigmatize mental health and the lasting effects that our environment can have on us. Trauma centered care is definitely a wave and a buzz word right now so I greatly hope that its study and implementation persist, which it likely will.
I LOVED Perry's honesty and reflection of his experience with Mama P. I feel like their interaction is something that often occurs. Medical professionals can have a difficult time empowering patients and abdicating their knowledge and power. The fact that Perry could truthfully share that he could have handled the interaction better was refreshing. It's important for every social worker to operate from a framework that encourages frequent learning and humility. Ultimately, Perry's willingness to learn from Mama P. led to positive outcomes for the children patients.
-Kimberly
I was sad the little girl had to go through the medical procedures as well. I understand it was important to rule out, but it would have been really nice to have the “full circle” care and look into possible mental and social reasons her failure to thrive was happening. I can’t even imagine the additional trauma the hospital trips made. I appreciate your optimism about the current environment and how more professionals are becoming more trauma informed. I agree that it is spreading teachers, doctors, nurses, cops, firemen…it’s all the rage, and it should be! I think it was amazing that Dr. Perry let Mama P be the expert of her own experience, and didn’t use his degree as a power differential. I love how he created rapport by doing this.
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ReplyDeleteI also found the insistence of Laura's psychologist that she must have been experiencing some form of infantile anorexia, and the pursuit of that hypothesis to the exclusion of other potential etiologies for the sake of publication, to be upsetting. The idea that Laura would, for some unfathomable reason, be exercising excessively to lose weight at the age of 4 is flatly nonsense and does not seem to have any basis in the reality or circumstances of her case. And yet, to be honest, I'm ambivalent. The apparent inability or refusal of the psychologist to recognize the potential that his hypothesis may be incorrect is deserving of our criticism, certainly, but I can't help but imagine: what if he had been correct? I'm reminded of some of the breakthrough experiments of early psychology: the Milgram experiment, the Little Albert experiment, Harlow's monkeys, and many others. By modern standards in the ethics of experimental psychology, none of these studies would receive IRB approval, yet many of them – for better or worse – gave us key insights into the nature of human (or otherwise primate or mammalian) behavior.
ReplyDeleteI don't mean to excuse what was done to Laura by the medical professionals assigned to her care, or to argue that her psychologist was right to pursue knowledge over her well-being. I do, though, want to play devil's advocate and assert that we never know how close or far we are from great discovery and insight until we have it, and that the mysteries of our brains are concealed by a thin veil which can be penetrated under the right circumstances. If those circumstances arise naturally, should we avert our eyes from what they might teach us, or should we examine closely, to use them as a stepping stone, as you say, even if it means we may look upon suffering?
Your comment about letting the client be the expert is really interesting! I wonder sometimes if this quality is something that only social workers do, or if it is something that most helping professions know at some level. I think that at times, people can get caught up in their "education" and the various degrees that they have, and lose sight of what is important, the client. My hope is that with more and more client education, professionals can understand that its a team effort to get the client the help that they need. While we may have the formal education to aid in diagnosis or treatment, the client has the education of what works for them, and what is best for them at this moment.
ReplyDeleteThe word "fascinating" sticks out to me for some reason, and if I remember correctly, it was used in the chapter as well. It's incredibly disheartening to think that there are individuals in the medical field who are more "fascinated" than concerned about the individuals that they work with. Rather than making efforts to truly help their clients, there's at times instead a selfish interest to use the opportunities to, as you say, get an edge on their careers. And it really is all about the interactions with clients. Compassion and empathy go a long way, but this is often forgotten. I also don't mean to suggest that compassion and empathy are always the answer, because surely there are times where medical interventions/procedures are necessary. But regardless, the care and support that clients need are often not there, and it can be detrimental to their progress and health.
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