What Makes Us Human

Book: Bruce D. Perry & Maia Szalavitz, The Boy Who Was Raised as a Dog (the essay also mentions Perry’s later book with Oprah Winfrey, What Happened to You?)

I want to begin with a case that shook my country: a sixteen-month-old adopted child who was neglected and abused until she died, and the public outrage that followed. Whatever sentence the courts hand down, the child cannot come back. Cases like this exist everywhere, and they force the same question: what does a child need in order to become fully human?

Child abuse is usually pictured as something done — a blow, a burning word, a threat. But among its forms, the one most easily overlooked is neglect: a caregiver failing to provide the food, shelter, schooling, or medical care a child needs, or abandoning them outright. This is the absence of what must be present in a child’s development — and it can harm as gravely as violence, sometimes more, with long shadows.

Reported cases have risen year over year. I suspect this reflects less a rise in abuse than a rise in awareness and reporting; more children now call for help themselves, and emotional abuse, not only physical, is increasingly recognized.

When trauma strikes during the most vulnerable, most protection-needing period of human development, the result is developmental trauma. In early life, safe and protective relationships build a child’s basic schema of trust in the world, support brain development, and lay the framework for physical and emotional regulation. Children raised with consistent, secure attachment tend to grow into well-regulated adults. Children raised amid inconsistency, abuse, and neglect often struggle with attention, live in hypervigilant overarousal, have trouble in relationships, go blank or dissociate, or cannot regulate behavior and emotion — and because the ordinary diagnosis of PTSD cannot hold developmental trauma, they are frequently labeled instead with ADHD, oppositional defiant disorder, disruptive mood dysregulation disorder, depression, or borderline personality.

The book’s author, Bruce Perry, is a psychiatrist who spent decades in child mental health and neuroscience and has advised many agencies on child-trauma cases; his later book with Oprah Winfrey, What Happened to You?, helped a wide public understand trauma and healing. The Boy Who Was Raised as a Dog is built from his own cases of abused children, and in it the worst tragedy and the best hope live side by side. Reading these accounts of survival — brutal beyond what the word “primitive” could describe, set against our fast, high-tech age — I sometimes felt something close to nausea at the gap, and turned each page with my heart in my throat, praying for the child’s recovery.

In the end, a child’s recovery from trauma and neglect is a process of restoring trust, regaining confidence, returning a sense of safety, and reconnecting the capacity to feel love. Healing happens in relationship. No matter how good the medication or the technique, healing is impossible without a continuous, caring relationship with another person. To become truly human, Perry writes, one must learn how to be human.

He argues that traumatized children need a rich social environment and a healthy community where they can belong and be loved — and he does not spare our present. Our dazzling modern society, he says, has abandoned many of the basic ingredients the human psyche requires; seen biologically, it is a poor world for a child. Children need healthy physical touch. To keep children safe we must form healthy human bonds and strengthen community, and we must build policy that respects a child’s needs and biology.

The Adverse Childhood Experiences (ACE) study made this concrete: adversity in childhood is linked to serious adult illness — chronic obstructive pulmonary disease, heart disease, liver disease, cancer, emphysema — so that child abuse and developmental trauma are matters of public health of the first order. When U.S. public health tallied the cost of illness arising from child maltreatment, it proved among the largest and most expensive problems of all.

Breaking the cycle of child abuse may be the most dignified thing that makes us human. From the generation that carries the will and the calling to sever inherited trauma, a history of flourishing will be written again.